Current Hypertension Reports最新文献

{"title":"Diagnosis of Primary Aldosteronism without Discontinuation of Interfering Antihypertensive Medications.","authors":"Zhichao Dong, Xiaoxiao Song, Minyue Jia, Jinliang Chen, Yuhao Zhang, Hanxiao Yu, Yongli Ji, Lizhen Shan, Tianyue Zhang, Chao Zheng, Jiaming Wen, Xiaohong Xu","doi":"10.1007/s11906-024-01319-y","DOIUrl":"10.1007/s11906-024-01319-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>One of the challenges in the diagnosis and management of primary aldosteronism (PA), the most common type of secondary hypertension with curative potential, is the modification of antihypertensive medications. We seek to explore whether these medications can be continued during the diagnostic process of PA to minimize the duration and risks associated with medication adjustments.</p><p><strong>Recent findings: </strong>We searched PubMed for eligible original literature between 1990 and 2024 using the following keywords: (screening) AND (primary aldosteronism); (confirmatory) AND (primary aldosteronism); (adrenal vein sampling) AND primary aldosteronism). Some recent studies support the feasibility of PA-related tests and even adrenal vein sampling (AVS) without the need to discontinue antihypertensive medications in certain cases. In this review, we propose a management approach that considers the specific effects of antihypertensive medications on the RAAS axis and the patient's disease phenotype. Based on this, we suggest a strategy that enables the diagnosis of PA in certain patients without discontinuing their antihypertensive medications.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":"27 1","pages":"4"},"PeriodicalIF":3.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Invasive Arterial BP Measurements in the Emergency Department-When, if Ever, is it Indicated?","authors":"Gurpreet Kaur, Thayer Morton, Marjon Khairy, Megan Foy, Jayna Gardner-Gray","doi":"10.1007/s11906-024-01321-4","DOIUrl":"10.1007/s11906-024-01321-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Extremes of blood pressure (BP) are common among patients that visit emergency departments. In this review article, we discuss the specific indications for invasive blood pressure monitoring in the ED, particularly in the context of undifferentiated shock and hypertensive emergencies.</p><p><strong>Recent findings: </strong>In most cases, non-invasive techniques suffice for blood pressure monitoring, however, in certain patient presentations intermittent automated oscillometry bears significant drawbacks. The most evident drawback is the extended intervals between measurements. Invasive BP (IBP) monitoring offers a pivotal tool for patients with critical illness who require accurate, timely, blood pressure monitoring and indirectly monitors for complications involving vital organ systems. In the management of patients with critical illness or at risk for end organ injury, invasive methods that directly measure BP via arterial cannulation continues to be an established standard. Overall, evaluating patients on an individual basis, with the understanding that patients who present with extreme blood pressure values need closer monitoring, should prompt consideration of invasive methods of blood pressure monitoring.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":"27 1","pages":"3"},"PeriodicalIF":3.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is There a Role for SGLT2 Inhibitors in Patients with End-Stage Kidney Disease?","authors":"Rehma Siddiqui, Yoshitsugu Obi, Neville R Dossabhoy, Tariq Shafi","doi":"10.1007/s11906-024-01314-3","DOIUrl":"10.1007/s11906-024-01314-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>Chronic kidney disease and end-stage kidney disease (ESKD) are well-established risk factors for cardiovascular disease (CVD), the leading cause of mortality in the dialysis population. Conventional therapies, such as statins, blood pressure control, and renin-angiotensin-aldosterone system blockade, have inadequately addressed this cardiovascular risk, highlighting the unmet need for effective treatment strategies. Sodium-glucose transporter 2 (SGLT2) inhibitors have demonstrated significant renal and cardiovascular benefits among patients with type 2 diabetes, heart failure, or CKD at risk of progression. Unfortunately, efficacy data in dialysis patients is lacking as ESKD was an exclusion criterion for all major clinical trials of SGLT2 inhibitors. This review explores the potential of SGLT2 inhibitors in improving cardiovascular outcomes among patients with ESKD, focusing on their direct cardiac effects.</p><p><strong>Recent findings: </strong>Recent clinical and preclinical studies have shown promising data for the application of SGLT2 inhibitors to the dialysis population. SGLT2 inhibitors may provide cardiovascular benefits to dialysis patients, not only indirectly by preserving the remaining kidney function and improving anemia but also directly by lowering intracellular sodium and calcium levels, reducing inflammation, regulating autophagy, and alleviating oxidative stress and endoplasmic reticulum stress within cardiomyocytes and endothelial cells. This review examines the current clinical evidence and experimental data supporting the use of SGLT2 inhibitors, discusses its potential safety concerns, and outlines ongoing clinical trials in the dialysis population. Further research is needed to evaluate the safety and effectiveness of SGLT2 inhibitor use among patients with ESKD.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":" ","pages":"463-474"},"PeriodicalIF":3.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11455675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances on the Experimental Research in Resistant Hypertension.","authors":"Maria Claudia Irigoyen, Claudia Fetter, Kátia De Angelis","doi":"10.1007/s11906-024-01315-2","DOIUrl":"10.1007/s11906-024-01315-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Resistant Hypertension (RH) poses a significant public health challenge, contributing to increased mortality, cardiovascular events and organ damage. Both clinical and experimental research are striving for higher standards in a translational manner to integrate new findings and confirm hypotheses. Considering that many are the aspects of RH that are still under investigation, this review aims to shed light on the advances made in experimental research concerning RH. It seeks to underscore the pivotal role of experimental studies in shaping clinical practices and also explore future perspectives.</p><p><strong>Recent findings: </strong>It is important to emphasize the significance of experimental models, primarily for advancing our understanding: experimental models have greatly contributed to our comprehension of the underlying mechanisms in RH, including factors like sympathetic activation, endothelial dysfunction and structural vessel abnormalities. Secondly, for assessing treatment approaches: animal models have also played a crucial role in evaluating the potential effectiveness of diverse treatment approaches for RH. These encompass both pharmacological options, involving combinations of established drugs or novel pharmaceuticals, and non-pharmacological alternatives, which include surgical procedures like renal denervation, medical devices like baroreceptor stimulators, and lifestyle modifications. The most lacking component in translational research is the fact that there is no well-established animal model that perfectly replicates RH. Consequently, alternative strategies, including the combination of models, must be considered. What remains clear is that the development of animal models closely mimicking RH holds the promise of providing valuable insights into the essential mechanisms and responses necessary to combat or slow the global progression of RH.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":" ","pages":"475-482"},"PeriodicalIF":3.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of the (Pro)renin Receptor in Activating the Renin-Angiotensin System During Normotensive and Preeclamptic Pregnancies.","authors":"Lachlan G Schofield, Saije K Endacott, Sarah J Delforce, Eugenie R Lumbers, Kirsty G Pringle","doi":"10.1007/s11906-024-01316-1","DOIUrl":"10.1007/s11906-024-01316-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>For a healthy pregnancy to occur, a controlled interplay between the maternal circulating renin-angiotensin-aldosterone system (RAAS), placental renin-angiotensin system (RAS) and intrarenal renin-angiotensin system (iRAS) is necessary. Functionally, both the RAAS and iRAS interact to maintain blood pressure and cardiac output, as well as fluid and electrolyte balance. The placental RAS is important for placental development while also influencing the maternal circulating RAAS and iRAS. This narrative review concentrates on the (pro)renin receptor ((P)RR) and its soluble form (s(P)RR) in the context of the hypertensive pregnancy pathology, preeclampsia.</p><p><strong>Recent findings: </strong>The (P)RR and the s(P)RR have become of particular interest as not only can they activate prorenin and renin, thus influencing levels of angiotensin II (Ang II), but s(P)RR has now been shown to directly interact with and stimulate the Angiotensin II type 1 receptor (AT₁R). Levels of both placental (P)RR and maternal circulating s(P)RR are elevated in patients with preeclampsia. Furthermore, s(P)RR has been shown to increase blood pressure in non-pregnant and pregnant rats and mice. In preeclamptic pregnancies, which are characterised by maternal hypertension and impaired placental development and function, we propose that there is enhanced secretion of s(P)RR from the placenta into the maternal circulation. Due to its ability to both activate prorenin and act as an AT₁R agonist, excess maternal circulating s(P)RR can act on both the maternal vasculature, and the kidney, leading to RAS over-activation. This results in dysregulation of the maternal circulating RAAS and overactivation of the iRAS, contributing to maternal hypertension, renal damage, and secondary changes to neurohumoral regulation of fluid and electrolyte balance, ultimately contributing to the pathophysiology of preeclampsia.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":" ","pages":"483-495"},"PeriodicalIF":3.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11455731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141874385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting the Brain Leptin-Melanocortin Pathway to Treat Heart Failure.","authors":"Ana C M Omoto, Jussara M do Carmo, Alan J Mouton, Zhen Wang, Xuan Li, Robert Spitz, John E Hall, Alexandre A da Silva","doi":"10.1007/s11906-024-01318-z","DOIUrl":"10.1007/s11906-024-01318-z","url":null,"abstract":"<p><strong>Purpose of the review: </strong>The role of leptin in regulating cardiac function is still controversial with conflicting results in clinical and preclinical studies. However, most previous studies have not considered leptin's powerful cardiac effects that are mediated via activation of central nervous system (CNS) leptin receptors (LepRs) which, in turn, elicit major improvements in cardiac metabolism. In this review, we focus mainly on the role of leptin in regulating cardiac function via its CNS LepRs and downstream signaling pathways, such as the brain melanocortin system.</p><p><strong>Recent findings: </strong>Studies from our laboratory showed that CNS LepR activation, without raising plasma leptin levels, has remarkable beneficial effects on cardiac metabolism and function that protect the heart during pathological conditions, including heart failure (HF) induced by myocardial infarction (MI). These cardioprotective effects of leptin appear to be mediated by stimulation of CNS proopiomelanocortin neurons and subsequent activation of melanocortin 4 receptors (MC4R) in the brain. Chronic activation of the brain leptin-melanocortin pathway improves cardiac function and metabolism following myocardial infarction. However, the mechanism underlying this brain-heart crosstalk remains unclear and may have important implications for the development of new therapies for MI and HF.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":"27 1","pages":"2"},"PeriodicalIF":3.9,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intradialytic Hypertension in Maintenance Hemodialysis.","authors":"Fotini Iatridi, Marieta P Theodorakopoulou, Artemios G Karagiannidis, Pantelis Sarafidis","doi":"10.1007/s11906-024-01320-5","DOIUrl":"10.1007/s11906-024-01320-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarize the current evidence regarding epidemiology, clinical pathophysiology, and latest therapeutic approaches for the management of intradialytic hypertension (IDH).</p><p><strong>Recent findings: </strong>IDH is a rather common complication of dialysis, affecting 10-15% of the patient population and significantly increasing the cardiovascular risk. Its pathophysiology involves multiple mechanisms, including volume and sodium overload, sympathetic nervous system (SNS) and renin-angiotensin-aldosterone system (RAAS) overactivity, endothelial dysfunction, and arterial stiffness. IDH management requires a combination of nonpharmacological and pharmacological interventions. The first mainly focus on volume control through dry weight optimization and modification of dialysate sodium, as studies show that strict volume control or low dialysate sodium can significantly reduce intradialytic and ambulatory blood pressure (BP). Pharmacological interventions have also been examined in research studies. Beta-blockers, particularly those with vasodilatory properties, can effectively target mechanisms such as SNS overactivity and endothelial dysfunction, and have shown some promising results reducing both intradialytic and ambulatory BP. Other drugs classes have also been explored as potential therapeutic options for IDH management, though further research is needed to clarify the efficacy of these interventions. A tailored approach addressing both the underlying pathophysiological mechanisms and individualized patient is warranted for improving BP control and cardiovascular outcomes in this high-risk population.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":"27 1","pages":"1"},"PeriodicalIF":3.9,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beneficial Effects of Exercise on Hypertension-Induced Cardiac Hypertrophy in Adolescents and Young Adults.","authors":"Takeshi Tsuda, Bradley W Robinson","doi":"10.1007/s11906-024-01313-4","DOIUrl":"10.1007/s11906-024-01313-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Hypertension-induced cardiac hypertrophy is widely known as a major risk factor for increased cardiovascular morbidity and mortality. Although exercise is proven to exert overall beneficial effects on hypertension and hypertension-induced cardiac hypertrophy, there are some concerns among providers about potential adverse effects induced by intense exercise, especially in hypertensive athletes. We will overview the underlying mechanisms of physiological and pathological hypertrophy and delineate the beneficial effects of exercise in young people with hypertension and consequent hypertrophy.</p><p><strong>Recent findings: </strong>Multiple studies have demonstrated that exercise training, both endurance and resistance types, reduces blood pressure and ameliorates hypertrophy in hypertensives, but certain precautions are required for hypertensive athletes when allowing competitive sports: Elevated blood pressure should be controlled before allowing them to participate in high-intensity exercise. Non-vigorous and recreational exercise are always recommended to promote cardiovascular health. Exercise-induced cardiac adaptation is a benign and favorable response that reverses or attenuates pathological cardiovascular remodeling induced by persistent hypertension. Exercise is the most effective nonpharmacological treatment for hypertensive individuals. Distinction between recreational-level exercise and competitive sports should be recognized by medical providers when allowing sports participation for adolescents and young adults.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":" ","pages":"451-462"},"PeriodicalIF":3.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Blood Pressure and Cardiovascular Health in Adulthood.","authors":"Yaxing Meng, Jonathan P Mynard, Kylie J Smith, Markus Juonala, Elaine M Urbina, Teemu Niiranen, Stephen R Daniels, Bo Xi, Costan G Magnussen","doi":"10.1007/s11906-024-01312-5","DOIUrl":"10.1007/s11906-024-01312-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes current knowledge on blood pressure in children and adolescents (youth), with a focus on primary hypertension-the most common form of elevated blood pressure in this demographic. We examine its etiology, progression, and long-term cardiovascular implications. The review covers definitions and recommendations of blood pressure classifications, recent developments in measurement, epidemiological trends, findings from observational and clinical studies, and prevention and treatment, while identifying gaps in understanding and suggesting future research directions.</p><p><strong>Recent findings: </strong>Youth hypertension is an escalating global issue, with regional and national variations in prevalence. While the principles of blood pressure measurement have remained largely consistent, challenges in this age group include a scarcity of automated devices that have passed independent validation for accuracy and a generally limited tolerance for ambulatory blood pressure monitoring. A multifaceted interplay of factors contributes to youth hypertension, impacting long-term cardiovascular health. Recent studies, including meta-analysis and sophisticated life-course modelling, reveal an adverse link between youth and life-course blood pressure and subclinical cardiovascular outcomes later in life. New evidence now provides the strongest evidence yet linking youth blood pressure with clinical cardiovascular events in adulthood. Some clinical trials have expanded our understanding of the safety and efficacy of antihypertensive medications in youth, but this remains an area that requires additional attention, particularly regarding varied screening approaches. This review outlines the potential role of preventing and managing blood pressure in youth to reduce future cardiovascular risk. A global perspective is necessary in formulating blood pressure definitions and strategies, considering the specific needs and circumstances in low- and middle-income countries compared to high-income countries.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":" ","pages":"431-450"},"PeriodicalIF":3.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11455673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension and Cardiovascular Outcomes in Inflammatory and Autoimmune Diseases: A Systematic Review and Meta-analysis.","authors":"Marie Barozet, Olivier Le Tilly, Theodora Bejan-Angoulvant, Pierre Fesler, Camille Roubille","doi":"10.1007/s11906-024-01311-6","DOIUrl":"10.1007/s11906-024-01311-6","url":null,"abstract":"<p><strong>Purpose: </strong>This review aimed to investigate the prevalence of hypertension and cardiovascular (CV) complications in various inflammatory and autoimmune diseases (IAD).</p><p><strong>Recent findings: </strong>Despite recent improvements in the management of IAD, patients with IAD still have an increased CV mortality and CV complications, mostly related to CV risk factors such as hypertension and inflammation. We systematically searched MEDLINE and EMBASE libraries for controlled studies involving hypertension and CV complications in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), psoriasis including psoriatic arthritis (PsA), Sjogren's syndrome (SS), or antineutrophil cytoplasmic antibody-associated vasculitis (AAV) between January 2000 and March 2022. We extracted data on the prevalence of hypertension and CV complications. Then, random-effects meta-analyses and exploratory multivariate meta-regression were performed to explore factors related to the prevalence of hypertension. Of 2726 studies screened, 122 were selected for the meta-analysis. The prevalence of hypertension was higher among patients with IAD than controls, with an overall unadjusted odds ratio (OR) [95% confidence interval] of 1.67 [1.58-1.76] and an adjusted OR of 1.36 [1.24-1.50]. All diseases were found to be associated with increased risk of hypertension: SLE, adjusted OR 3.40 [1.93-6.00]; psoriasis, OR 1.32 [1.16-1.51]; PsA, OR 1.49 [1.15-1.94]; RA, OR 1.28 [1.04-1.58]; SS, OR 2.02 [1.19-3.44]. Age and female sex were significantly associated with hypertension in patients with IAD. The risk of CV complications was increased: ischemic heart disease, adjusted OR 1.38 [1.21-1.57]; cerebrovascular disease, OR 1.37 [1.03-1.81]; heart failure, OR 1.28 [1.05-1.55]; atherosclerotic plaques presence, OR 2.46 [1.84-3.29]. The prevalence of hypertension and CV complications is higher among patients with IAD. Screening and management of hypertension appears to be of paramount importance in these patients.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":" ","pages":"419-429"},"PeriodicalIF":3.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141179158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}