Clinics最新文献

{"title":"Correlation between liver volume drainage and clinical success after endoscopic biliary drainage of hilar malignant obstruction","authors":"Jennifer Nakamura Ruas ,&nbsp;Ernesto Quaresma Mendonça ,&nbsp;Luciano Lenz ,&nbsp;Gustavo Andrade de Paulo ,&nbsp;Ricardo Uemura Sato ,&nbsp;José Jukemura ,&nbsp;Ulysses Ribeiro Junior ,&nbsp;Fauze Maluf-Filho ,&nbsp;Bruno Costa Martins","doi":"10.1016/j.clinsp.2024.100540","DOIUrl":"10.1016/j.clinsp.2024.100540","url":null,"abstract":"<div><h3>Background and aim</h3><div>Malignant hilar obstruction usually presents in advanced-stage disease with a poor prognosis. Effective biliary drainage is essential for the beginning of palliative chemotherapy. There is a debate on the amount of liver parenchyma that should be drained to achieve clinical success. This study aimed to correlate the volume of liver drained with clinical success rate.</div></div><div><h3>Methods</h3><div>The authors conducted a retrospective study including patients with malignant hilar biliary obstruction who underwent retrograde endoscopic cholangiography for biliary drainage from January 2014 to December 2018. The main outcome was a correlation of clinical success rate with hepatic volume drained. Secondary outcomes were correlation of clinical success rate with the quantity of liver sectors drained and unilateral versus bilateral drainage.</div></div><div><h3>Results</h3><div>82 patients met inclusion criteria (58.5 % female), with a mean age of 60±13 years. The main cause of hilar obstruction was cholangiocarcinoma (32.9 %) followed by lymph node metastasis (23.2 %). Technical success was achieved in 75 patients (91.5 %), and clinical success in 45 patients (60 %). The authors found a significant correlation between clinical success rate when at least 50 % of viable parenchyma was drained (p = 0.016; OR = 4.15, 95 % CI 1.4–12.5). Considering liver sectors, higher clinical success rates were found when at least 2 sectors were drained (p &lt; 0.001; OR = 8.50, 95 % CI 2.7–26.7). The correlation between unilateral versus bilateral drainage and clinical success was not statistically significant.</div></div><div><h3>Conclusion</h3><div>Drainage of at least 50 % of volume hepatic parenchyma was associated with better outcomes as well as drainage of at least 2 hepatic sectors, regardless of if unilateral or bilateral.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100540"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766843","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":"Comments on the article “Olanzapine as a prophylactic antiemetic for preventing postoperative nausea and vomiting after general anesthesia: A systematic review and meta-analysis”","authors":"Pedro Fernandes Ribeiro,&nbsp;Bianca Ramos,&nbsp;Tallys A. Suzuki,&nbsp;Giovanna Uyeda","doi":"10.1016/j.clinsp.2024.100569","DOIUrl":"10.1016/j.clinsp.2024.100569","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100569"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926580","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":"Relationship between sleep disorders and information processing speed in multiple sclerosis","authors":"Fereshteh Ashtari ,&nbsp;Arshia Ghalamkari ,&nbsp;Saba Naghavi ,&nbsp;Ahmad Pourmohammadi ,&nbsp;Iman Adibi ,&nbsp;Zahra Karimi ,&nbsp;Aryan Kavosh","doi":"10.1016/j.clinsp.2024.100574","DOIUrl":"10.1016/j.clinsp.2024.100574","url":null,"abstract":"<div><h3>Objectives</h3><div>It is estimated that up to 65 % of pwMS (people with multiple sclerosis) experience varying degrees of cognitive impairment, the most commonly affected domain being Information Processing Speed (IPS). As sleep disturbance is a predictor of detriments in IPS, the authors aimed to study the association between the severity of Restless Legs Syndrome (RLS) and Obstructive Sleep Apnea (OSA) symptoms with IPS in pwMS.</div></div><div><h3>Methods</h3><div>In a cross-sectional study, the authors enrolled people with relapsing-remitting and secondary progressive MS referred to the comprehensive MS center of Kashani Hospital in Isfahan, Iran. The authors used Berlin and STOP-Bang questionnaires for assessing OSA symptoms, and the International Restless Legs Syndrome Study Group (IRLSSG) scale for the presence and severity of symptoms of RLS. The authors used the Integrated Cognitive Assessment (ICA) test, a language and education-independent tool, to assess visual processing speed.</div></div><div><h3>Results</h3><div>The authors included 211 pwMS, with a mean age of 36.73 ± 8.9 (81.9 % female). PwMS with higher RLS scores showed lower IPS, with ICA indexes of 0.66 ± 0.09 vs. 0.61 ± 0.12 in low- and high-risk RLS groups, respectively (p &lt; 0.01). There were no significant associations between IPS as measured by the ICA index and OSA symptom severity.</div></div><div><h3>Conclusion</h3><div>The authors found impairments in IPS in pwMS to be linked with the severity of RLS symptoms, but not with OSA. Considering the high prevalence and underdiagnosis of RLS in pwMS, and the profound impact of IPS on quality of life, this association highlights the importance of screening and treating RLS in this population.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100574"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028124","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":"Evaluation of l-cell activity in the small intestine according to the extension of the biliopancreatic loop in patients undergoing Roux-en-Y gastric by-pass","authors":"Priscila Costa Estabile,&nbsp;Márcia Saldanha Kubrusly,&nbsp;Robson Kiyoshi Ishida,&nbsp;André Bubna Hirayama,&nbsp;Roberto de Cleva,&nbsp;Marco Aurelio Santo","doi":"10.1016/j.clinsp.2024.100555","DOIUrl":"10.1016/j.clinsp.2024.100555","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with severe obesity and type 2 diabetes mellitus have reduced secretion of incretins by L cells. Studies suggest an increase in L cell activity according to the length of the Biliopancreatic Loop (BPL).</div></div><div><h3>Objective</h3><div>Compare the effect of biliopancreatic loop extension on the number and expression of L cells in patients undergoing RYGB</div></div><div><h3>Methods</h3><div>Subjects (<em>n</em> = 13) undergoing RYGB with a BPL of 100 cm (G1) or 200 cm (G2). Intestinal biopsies were done before (T1) and 6 months after (T2) RYGB in 3 segments: gastro-enteric anastomosis (A), entero-enteric anastomosis (B) and terminal ileum (C). Analyzes of intestinal biopsies by immunohistochemistry and qRT-PCR.</div></div><div><h3>Results</h3><div>There was an increase (<em>p</em> &lt; 0.0001) in L cells marked by PYY and GLP1 between T1 (17 ± 10.5) and T2 (23.5 ± 10.7) only at point C. There was no difference in L cells expression between groups G1 and G2 at points A (A1: 17.3 ± 2.9; A2: 19.9 ± 1.9; <em>p</em> = 0.09), B (B1: 13.7 ± 6.6; B2: 14.1 ± 4.9; <em>p</em> = 0.89) and C (C1: 13.2 ± 2.2; C2: 11.4 ± 3.4; <em>p</em> = 0.32) in PYY and GLP1 gene expression (A1: 20.8 ± 4, 1; A2: 23.7 ± 3.6; <em>p</em> = 0.2), B (B1:14.3 ± 7.9; B2: 22.7 ± 11.8; <em>p</em> = 0.1), (C1: 17±4.1; C2: 21.1 ± 4.8; <em>p</em> = 0.2).</div></div><div><h3>Conclusions</h3><div>Both techniques lead to an increase in the number of active L cells.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100555"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045899","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":"circLOC375190 promotes autophagy through modulation of the mTORC1/TFEB axis in acute ischemic stroke-induced neurological injury","authors":"Qie Liu ,&nbsp;Lu Zhang ,&nbsp;Xin Xu","doi":"10.1016/j.clinsp.2025.100581","DOIUrl":"10.1016/j.clinsp.2025.100581","url":null,"abstract":"<div><h3>Objective</h3><div>The authors explored differentially expressed circRNAs in Acute Ischemic Stroke (AIS) and revealed the role and potential downstream molecular mechanisms of circLOC375190.</div></div><div><h3>Methods</h3><div>circLOC375190 expression was modulated by lentiviral injection in the brain of transient Middle Cerebral Artery Occlusion (tMCAO) mice. Neurological dysfunction was assessed, as well as infarction size, histopathological changes, and neuronal apoptosis in tMCAO mice. An in vitro Oxygen-Glucose Deprivation/Reoxygenation (OGD/R) PC-12 cell model was established. PC-12 cells were transfected and evaluated for viability, cytotoxicity, apoptosis, and autophagy. Inflammatory factors in mouse brain tissues and PC-12 cells were examined via enzyme-linked immunosorbent assay, and related genes were measured via real-time reverse transcriptase-polymerase chain reaction and Western blot. The ring structure of circLOC375190 was assessed by actinomycin-D and RNase-R assays. circRNA targeting to downstream factors was assessed by Fluorescence in situ hybridization assay, dual luciferase reporter assay, and RNA immunoprecipitation assay.</div></div><div><h3>Results</h3><div>circLOC375190 level was increased in tMCAO mice. Knocking down circLOC375190 reduced infarct size, attenuated cerebral pathological injury and neuronal apoptosis, and inhibited inflammatory damage and autophagy in tMCAO mice. circLOC375190 knockdown enhanced neuronal viability and reduced cytotoxicity, apoptosis, and autophagy in OGD/R-treated PC12 cells. Mechanistically, circLOC375190 acted as a sponge for miR-93-5p to upregulate MAP kinase interacting serine/threonine kinase 2 expression and activate the mechanistic target of rapamycin complex 1/transcription factor EB pathway.</div></div><div><h3>Conclusion</h3><div>circLOC375190 exacerbates tMCAO-mediated neurological injury by regulating neuronal autophagy.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100581"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063909","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":"The economic impact of Long-Acting Contraceptives (LARCs) on public health","authors":"Ana Claudia Marcelino ,&nbsp;Paula da Cunha Pereira ,&nbsp;Luis Bahamondes","doi":"10.1016/j.clinsp.2025.100598","DOIUrl":"10.1016/j.clinsp.2025.100598","url":null,"abstract":"<div><div>The incorporation of long-acting reversible contraceptives (LARCs) into reproductive health strategies is crucial for enhancing access to effective contraception and reducing unplanned pregnancies (UPs). Evidence shows that even a modest shift from short-acting methods to LARCs can yield significant cost savings and improve health outcomes, both for individuals and public health systems. By facilitating single-visit placements and expanding the training of multidisciplinary teams, including nurses, healthcare providers can increase access to these effective contraceptive options.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100598"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438091","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":"Diagnosis and management of acute abnormal uterine bleeding during menacme","authors":"Gabriela Pravatta-Rezende ,&nbsp;Cristina Laguna Benetti-Pinto ,&nbsp;Daniela Angerame Yela Gomes ,&nbsp;Ana Carolina Japur de Sá Rosa e Silva ,&nbsp;José Maria Soares Junior","doi":"10.1016/j.clinsp.2025.100608","DOIUrl":"10.1016/j.clinsp.2025.100608","url":null,"abstract":"<div><h3>Objective</h3><div>To provide a protocol for the diagnosis and management of Acute Abnormal Uterine Bleeding (AUB) during menacme, addressing common causes, clinical evaluation, and treatment options.</div></div><div><h3>Methods</h3><div>A review of current evidence and guidelines was performed to create a structured approach for healthcare professionals.</div></div><div><h3>Results</h3><div>Acute AUB, defined as excessive uterine bleeding unrelated to pregnancy, requires immediate intervention. Causes vary by age and include coagulopathies, anovulation, and structural anomalies. Clinical stability, lab workups, and imaging are pivotal in guiding management. Initial treatment focuses on hemodynamic stabilization followed by medical therapies such as antifibrinolytics, hormonal agents, or surgical intervention when necessary.</div></div><div><h3>Conclusion</h3><div>Early intervention in AUB ensures optimal outcomes, reduces complications, and allows transition to maintenance therapy to prevent recurrence.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100608"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143579987","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":"Impact of the association of strength training with neuromuscular electrostimulation on the functionality of individuals with functional decline during senescence: A systematic review and meta-analysis","authors":"Dhianey de Almeida Neves ,&nbsp;Leonardo Costa Pereira ,&nbsp;Kerolyn Ramos Garcia ,&nbsp;Frederico Santos de Santana ,&nbsp;Rhenan Yoshio de Caldas Fujita ,&nbsp;Beatriz dos Santos Faria ,&nbsp;José Antônio Alves de Oliveira ,&nbsp;Carlos James Zeidan Silva Filho ,&nbsp;Margô Gomes de Oliveira Karnikowski","doi":"10.1016/j.clinsp.2025.100586","DOIUrl":"10.1016/j.clinsp.2025.100586","url":null,"abstract":"<div><h3>Introduction</h3><div>One of the parameters observed in functional capacity over the years is the decrease in neuromuscular responses, a fact that is attributed to the contemporary lifestyle. Thus, there is a need to carry out interventions that induce the improvement of functional capacity. Some studies have associated electrostimulation (NMES) with Strength Training (ST) to enhance the results in improving neuromuscular function. However, little is known about the effects of this association due to the numerous protocols to be manipulated. Furthermore, adaptive responses to strength training are dependent on volume and intensity manipulation.</div></div><div><h3>Objective</h3><div>To investigate the influence of ST, concomitant with NMES (NMES+) on functional capacity.</div></div><div><h3>Methods</h3><div>This is a systematic review with meta-analysis. For the search of the articles, descriptors associated with functional capacity and NMES+ were selected in the Cochrane, PubMed, Embase and VHL meta-searcher databases. Inclusion criteria were articles that presented neuromuscular electrostimulation superimposed on voluntary contraction and ST intensity control; and that did not have a therapeutic purpose. The analysis of titles, abstracts and data extraction were performed by trios of reviewers. To assess the qualities of scientific evidence, the risk of bias was analyzed through the ROB2 tool, meta- analysis and evaluation of the quality of evidence (GRADE).</div></div><div><h3>Results</h3><div>This meta-analysis selected 3 studies. The main outcomes observed in the studies were agility, balance, cardiorespiratory capacity and strength and power. A significant improvement in effect estimates for cardiorespiratory capacity alone was observed between the two studies.</div></div><div><h3>Conclusion</h3><div>Despite the significant effect of the use of NMES+, in relation to ST in isolation, the quality of the evidence was considered low, probably due to the limited number of scientific evidence found, requiring further studies to identify the real effect of this association.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100586"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350039","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":"Recognition of medical error: It is not too late for an open disclosure – a narrative review","authors":"Ivan Dieb Miziara ,&nbsp;Carmen Silvia Molleis Galego Miziara","doi":"10.1016/j.clinsp.2025.100622","DOIUrl":"10.1016/j.clinsp.2025.100622","url":null,"abstract":"<div><div>A medical error is a preventable adverse effect of medical care. These errors are usually avoidable. They are a vast source of ethical, financial, and even mental problems affecting patients, physicians, and healthcare organizations. The negative impact on patients can be physical, generating sequelae or disability. It could lead to a loss of trust in the patient and his family in the doctor or the hospital where he has been treated.</div><div>On the other hand, doctors resist disclosing their errors to the patient, fearing lawsuits and financial losses. Disclosure errors are also an imperative moral duty. In this narrative review, the authors discuss obstacles that exist and prevent an adequate open disclosure, including flaws in medical education, and propose ten steps to proceed with an open disclosure if a medical error occurs.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100622"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662491","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":"Sex differences in kidney and lung status in an animal model of brain death","authors":"Marina Vidal-dos-Santos ,&nbsp;Roberto Armstrong-Jr ,&nbsp;Maryna van Zil ,&nbsp;Fernanda Yamamoto Ricardo-da-Silva ,&nbsp;Lucas Ferreira da Anunciação ,&nbsp;Mayara Munhoz de Assis Ramos ,&nbsp;Cristiano de Jesus Correia ,&nbsp;Petra J. Ottens ,&nbsp;Luiz Felipe Pinho Moreira ,&nbsp;Henri G.D. Leuvenink ,&nbsp;Ana Cristina Breithaupt-Faloppa","doi":"10.1016/j.clinsp.2025.100623","DOIUrl":"10.1016/j.clinsp.2025.100623","url":null,"abstract":"<div><h3>Background</h3><div>In transplantation, sex-mismatched procedures correlate with poorer outcomes. Previous research has indicated that females respond worst to Brain Death (BD) and that organ damage varies with the speed of BD induction. The authors aimed to investigate the effects of slow BD-induction on lung and kidney responses in male and female rats.</div></div><div><h3>Methods</h3><div>Males and female rats were subjected to slow induction of BD and kept for 4h. Blood gas samples were taken at 0 h and 4h. At 4 h, blood, urine and tissue samples were collected. IL-1β was measured in plasma, lung homogenate and lung culture. IL-6 was quantified in plasma, lung culture, and kidney homogenate. Leukocyte infiltration/activation was evaluated. Biochemical analyses of creatinine were performed in the plasma. Naïve animals were used as controls.</div></div><div><h3>Results</h3><div>Males presented reduced testosterone levels after 4h. Females presented reduced progesterone, whereas estradiol remained similar at 0 h and 4h. Compared with Naive, BD-groups presented increased plasma IL-1β and IL-6. Males and females presented reduced pO₂ after BD, with females presenting even lower values at 4h. In lung tissue, males presented increased expression of IL-1β, whereas IL-1β was elevated in females in lung culture. Females presented increased cell infiltration/activation. In the kidney, males presented increased plasma creatinine, increased expression of caspase-3, and increased leukocyte migration to renal tissue than females.</div></div><div><h3>Conclusions</h3><div>The authors observed an organ and sex-dependent response to the slow-induction of BD. These results suggest that management strategies should consider the sex of the donor to achieve the best treatment, improving graft quality.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100623"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704165","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}