European Journal of Clinical Microbiology & Infectious Diseases最新文献

{"title":"Lab efficiency and improvements in the management of bloodstream infections: a before and after study.","authors":"Maxime Paluch, Nicolas Ettahar, Benjamin Lagraulet, Christian Cattoen, Eric Rethore, Arnaud Dubrulle, Lélia Abad, Frédérique Canis, Laura Wayenberg, Fabien Lambiotte, Gisèle Dewulf","doi":"10.1007/s10096-025-05200-x","DOIUrl":"10.1007/s10096-025-05200-x","url":null,"abstract":"","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2465-2474"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607776","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":"Molecular detection and serotyping of acute bacterial meningitis pathogens in Indian children.","authors":"Geetha Nagaraj, Vandana Govindan, C P Girish Kumar, Shally Awasthi, Bimal Kumar Das, Hitender Gautam, Debasis Biswas, S Ezhilarasi, S Nivedhana, Ashish Bavdekar, Ravikumar Kadahalli Lingegowda","doi":"10.1007/s10096-025-05198-2","DOIUrl":"10.1007/s10096-025-05198-2","url":null,"abstract":"<p><strong>Background: </strong>Acute bacterial meningitis (ABM) is a medical emergency that requires early diagnosis and prompt treatment. Understanding bacterial etiology and resistance patterns is critical for optimal management and reduction of mortality. Nucleic acid amplification tests, with high sensitivity and rapid results, are valuable for diagnosing ABM. This study aimed to identify the etiological agents of acute bacterial meningitis in children aged 1-59 months in India.</p><p><strong>Materials and methods: </strong>2004 CSF were collected from Children aged 1-59 months admitted to the ward/ ICU of seven study sites with probable meningitis between 2019 and 2023. The samples were subjected to conventional culture, 16s rRNA PCR, real-time Multiplex PCR for detecting S.pneumoniae, H.influenzae type b, N.meningitidis, and Quadraplex real-time Multiplex PCR to determine S.pneumoniae serotypes.</p><p><strong>Results: </strong>A total of 2,004 cerebrospinal fluid (CSF) samples were analysed for ABM in children over a 51-month period. The majority of cases (61%) involved children aged 0-12 months, with males comprising 63% of the study population. Laboratory confirmation identified ABM pathogens in 13.6% of cases, predominantly S.pneumoniae (10.2%), followed by H.influenzae (2.3%) and N.meningitidis (1%). Serotyping revealed 20 pneumococcal serotypes, with 19 F, 6 A, and 6B being the most prevalent, and 32.5% resistance to ceftriaxone was observed among pneumococcal isolates.</p><p><strong>Conclusion: </strong>This study underscores the diagnostic value of molecular techniques in accurately determining the burden of ABM in young children, with Streptococcus pneumoniae identified as the predominant pathogen. These findings underscore the need for molecular methods, enhanced vaccination coverage, and continued surveillance to monitor pathogen prevalence, serotype distribution, and antimicrobial resistance patterns.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2355-2368"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravenous combined with nebulized polymyxin B may be effective in treating carbapenem-resistant gram-negative bacilli hospital-acquired pneumonia: a retrospective cohort study.","authors":"Ye Zhang, Jiangtao Chen, Lexin Fang, Min Wang, Wenqing Zeng, Yueping Ding","doi":"10.1007/s10096-025-05208-3","DOIUrl":"10.1007/s10096-025-05208-3","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical efficacy and safety of intravenous polymyxin B versus the combination of intravenous and nebulized polymyxin B for treating carbapenem-resistant gram-negative bacilli hospital-acquired pneumonia (CRGNB-HAP), and to explore the risk factors affecting 28-day all-cause mortality.</p><p><strong>Method: </strong>Our retrospective analysis was conducted on data from CRGNB-HAP patients treated in the intensive care unit (ICU) with either intravenous polymyxin B alone or in conjunction with nebulized polymyxin B between November 28, 2018 and May 6, 2024. The primary endpoint was 28-day all-cause mortality, while safety outcomes were also assessed. Logistic regression analysis was utilized to identify the risk factors associated with 28-day all-cause mortality.</p><p><strong>Result: </strong>A total of 82 CRGNB-HAP patients were enrolled, including 38 patients in the intravenous plus nebulized (IV + NL) polymyxin B group and 44 patients in the intravenous (IV) polymyxin B group. The 28-day mortality rate of the IV + NL polymyxin B group was significantly lower than that of the IV polymyxin B group (23.7% vs 61.4%, p < 0.001), and there was no statistically significant difference in the incidence of acute kidney injury between the two groups. Multivariate logistic regression analysis indicated that IV + NL polymyxin B administration was a significant factor in reducing the 28-day mortality rate of CRGNB-HAP patients.</p><p><strong>Conclusion: </strong>Our study found that intravenous combined with nebulized polymyxin B therapy is superior to intravenous monotherapy in the treatment of CRGNB-HAP, resulting in reduced 28-day mortality without increasing renal toxicity.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2427-2437"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590759","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":"Cholecystitis associated with Q fever: case report and systematic review.","authors":"Aymery Stheme de Jubécourt, Marie Hocquart, Olivier Picaud, Georges Farvacque, Sophie Edouard, Louis Beaudoin, Romain Bitoun, Hubert Lepidi, Florence Fenollar, Pierre-Edouard Fournier, Matthieu Million","doi":"10.1007/s10096-025-05193-7","DOIUrl":"10.1007/s10096-025-05193-7","url":null,"abstract":"<p><strong>Background: </strong>Coxiella burnetii is an underestimated cause of acalculous cholecystitis. Large studies recently allowed to identify a dose-dependent association with IgG anticardiolipin. The management and long-term complications of Q fever-associated cholecystitis remain to be determined.</p><p><strong>Methods: </strong>We describe a surgical case from Martigues, France, which is an endemic area and performed a systematic review of C. burnetii cholecystitis cases associated with Q Fever.</p><p><strong>Results: </strong>Twenty-seven patients were included, including 3 (11.1%) children. All cases were reported during acute Q fever, followed by recurrent pancreatitis and chronic cholecystitis in 1 (3.7%) case. Two (2/2, 100%) were proven by a positive PCR on gallbladder but immunohistochemistry was negative in all cases. Only 3 (11.1%) cases were calculous. Coxiella burnetii cholecystitis is atypic because it is acalculous, with a flu-like syndrome, lupus anticoagulant, anticardiolipin antibodies and thrombocytopaenia.</p><p><strong>Conclusions: </strong>Serology and PCR from blood and gallbladder biopsies are key to the aetiological diagnosis of C. burnetii cholecystitis. Inflammatory and/or autoimmune mechanism is suspected. Doxycycline remains the first-line therapy. Future prospective studies should determine whether treatment with doxycycline and hydroxychloroquine can prevent the chronic evolution of the disease in patients who initially present with antiphospholipid antibodies.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2287-2294"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590758","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":"The re-emergence of HMPV: a wake-up call for public health systems.","authors":"Faiz Ahmad, Bikash Kumar Sah, Ankit Kumar, Saurabh Singh Baghel, Sachin Kumar Singh","doi":"10.1007/s10096-025-05210-9","DOIUrl":"10.1007/s10096-025-05210-9","url":null,"abstract":"","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2555-2557"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors of concurrent bacteremia in children under 5 years of age hospitalized with viral lower respiratory tract infections.","authors":"Nursel Atay Ünal, Meltem Polat, Elif Ayça Şahin, Sidre Erganiş, Tuğba Bedir Demirdağ, Okşan Derinöz Güleryüz, Hasan Tezer, Anıl Tapısız","doi":"10.1007/s10096-025-05211-8","DOIUrl":"10.1007/s10096-025-05211-8","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to investigate the prevalence and risk factors of concurrent bacteremia in otherwise healthy children under 5 years of age hospitalized with PCR-confirmed viral lower respiratory tract infections (VLRTIs), and to assess the impact of the COVID-19 pandemic on its prevalence and etiology.</p><p><strong>Methods: </strong>This retrospective study included children (≤ 5 years) hospitalized with PCR-confirmed VLRTIs between January 2018 and December 2024. Based on microbiology results obtained within 24 h of admission, we assessed the presence of concurrent, community-acquired bacteremia. Risk factors for bacteremia were evaluated using multivariate logistic regression.</p><p><strong>Results: </strong>Among 1845 patients, concurrent bacteremia was identified in 36 (1.9%) patients with influenza- and respiratory syncytial virus (RSV)-associated LRTIs. Age ≤ 6 months [adjusted odds ratio (aOR) 14.6, 95% confidence interval (CI) 5.7-37.5], C-reactive protein (CRP) ≥ 4 mg/dL (aOR 3.9, 95% CI 1.5-9.8), fever (≥ 39 °C) (aOR 4.8, 95% CI 1.3-18.0), and the need for advanced respiratory support (aOR 8.3, 95% CI 3.0-23.2) were independently associated with an increased risk of bacteremia. In the post-pandemic period, a significant shift in pathogen distribution was observed, with gram-negative bacteria, particularly Klebsiella spp., emerging as the predominant cause of bacteremia.</p><p><strong>Conclusion: </strong>Although rare, concurrent bacteremia was associated with high fever, elevated CRP levels, the need for advanced respiratory support, and an age of ≤ 6 months in children hospitalized with RSV and influenza associated LRTIs. Notably, gram-negative bacteria, particularly Klebsiella spp., emerged as predominant pathogens in the post-pandemic period, suggesting a potential shift in the epidemiology of bacteremia associated with VLRTIs.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2447-2455"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenotypic and genotypic antimicrobial resistance profiles of clinical Clostridioides difficile isolates collected from private and public health settings in South Africa.","authors":"Hlambani Shirinda, Anthony M Smith, Mohamed Said, Ben Prinsloo, Mishalan Moodley, Marleen M Kock, Marthie M Ehlers","doi":"10.1007/s10096-025-05205-6","DOIUrl":"10.1007/s10096-025-05205-6","url":null,"abstract":"<p><strong>Purpose: </strong>Antimicrobial resistance (AMR) is important in the pathogenesis and spread of Clostridioides difficile infection (CDI). However, very little is known about the association of AMR and C. difficile in South Africa. The present study aimed to investigate the phenotypic and genotypic antimicrobial profiles of clinical C. difficile isolates.</p><p><strong>Methods: </strong>Phenotypic antimicrobial susceptibility testing (AST) and whole genome sequencing (WGS) were used to characterize the isolates.</p><p><strong>Results: </strong>The AST showed that 43 isolates were susceptible to metronidazole and vancomycin. The WGS revealed a PnimB promoter mutation associated with reduced metronidazole susceptibility in all sequence type (ST) 1 strains (42%, 18/43). No vancomycin resistance determinants were found. Distinct lineages displayed specific resistance traits, such as fluoroquinolone resistance in ST1 strains due to a DNA gyrase (gyrA) mutation (Thr82Ile) and multidrug resistance (MDR) in ST37 strains, which contained resistance determinants for five antimicrobial classes. Overall, 95% (40/43) of strains had AMR determinants for at least three antimicrobial classes, indicating MDR. A qacG efflux pump gene, conferring resistance to disinfectants, was found in all strains.</p><p><strong>Conclusion: </strong>Antimicrobial resistance to metronidazole and vancomycin remains rare, however, high MDR prevalence particularly among ST1 and ST37 strains, suggests a risk of AMR gene transmission to other pathogens. The high rate of MDR C. difficile may reflect extensive antimicrobial use driven by comorbidities in immunocompromised individuals, contributing to AMR. These findings underscore the importance of ongoing AMR surveillance, effective antimicrobial stewardship and infection control to manage CDI and mitigate AMR spread.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2439-2445"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599675","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":"Tuberculosis in Turkiye: Epidemiological insights and recommendations for progress.","authors":"Defne Yigci, İlker Kayı, Yusuf Ziya Demiroğlu, Murat Kutlu, Zeki Kılıçaslan, Önder Ergönül","doi":"10.1007/s10096-025-05201-w","DOIUrl":"10.1007/s10096-025-05201-w","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains a significant global public health challenge. We provide an overview of the current TB epidemiology in Turkey, highlighting key findings related to TB incidence, diagnostic challenges, and treatment outcomes.</p><p><strong>Results: </strong>A gradual decline in TB incidence in Turkiye has been observed over recent years. In 2022, the TB incidence rate was 11.5 per 100,000, falling short of achieving WHO's target of a 50% reduction by 2025. The prevalence of multidrug-resistant TB (MDR-TB) is rising, particularly among foreign-born populations, and delays in diagnosing extrapulmonary TB forms, such as TB meningitis and spondylodiscitis, continue to hinder effective treatment.</p><p><strong>Conclusion: </strong>We identify critical gaps in diagnostic tools, treatment adherence, and healthcare worker knowledge. We provide a set of comprehensive recommendations aimed at reducing TB incidence and improving treatment success, including the implementation of rapid molecular diagnostic tests, strengthening health policies for at-risk populations (such as migrants), improving healthcare worker education, and leveraging mobile health platforms to monitor treatment adherence.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2323-2330"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical analysis of Mycoplasma pneumoniae pneumonia combined with adenovirus infection in children with lobar pneumonia.","authors":"Meiying Piao, Na Liu, Fanyang Meng, Hang Liang","doi":"10.1007/s10096-025-05194-6","DOIUrl":"10.1007/s10096-025-05194-6","url":null,"abstract":"<p><strong>Objective: </strong>Mycoplasma pneumoniae (MP) is a major pathogen that causes community-acquired pneumonia in children with a high rate of co-infection. Human adenovirus (HAdV) is a common co-infecting pathogen. This study aimed to analyze the clinical characteristics of children with lobar pneumonia caused by co-infection with MP and HAdV, and to investigate the correlation between the MP mutation sequence ratio (mutation depth/MP count) and HAdV sequence count with disease severity, thus providing evidence for clinical diagnosis and treatment.</p><p><strong>Methods: </strong>Children with MP-infected lobar pneumonia hospitalized in the Department of Pediatric Respiratory Medicine at the First Hospital of Jilin University from September to November 2023 were enrolled in this study and divided into MP and MP + HAdV groups. Clinical manifestations, laboratory examinations, and treatments were compared between the two groups. Correlations of the MP mutation sequence ratio and HAdV sequence count with clinical manifestations, laboratory examinations, and treatments were analyzed.</p><p><strong>Results: </strong>A total of 154 children with MP lobar pneumonia were included, with 96 cases in the MP group and 58 cases in the MP + HAdV group. The results showed that the MP + HAdV group had a longer total disease duration, fever duration, intravenous anti-MP drug administration duration, and systemic corticosteroid application duration, with a higher proportion of intravenous immunoglobulin use. The MP group had higher CRP levels and a higher incidence of pulmonary necrosis. After 10 days of treatment, the MP group showed better improvement in the pneumonia volume than the MP + HAdV group. There were no significant differences between the two groups in the length of hospital stay, peak fever, wheezing and rash, oxygen therapy proportion, or second-line anti-MP drug usage. No significant differences were observed between the two groups in the WBC, ESR, LDH, D-dimer, albumin, ALT, ferritin levels, incidence of atelectasis, pleural effusion, or bronchoscopy findings.</p><p><strong>Conclusion: </strong>Co-infection with HAdV can exacerbate the condition of children with MP lobar pneumonia and increase treatment difficulty. Higher MP mutation sequence ratios are associated with more severe airway mucosal damage, and higher HAdV viral loads correlate with more severe disease.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2331-2341"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological and clinical predictors of murine typhus in hospitalized patients in central israel: association with urban construction.","authors":"Iris Zohar, Inas Jarjoura, Debby Ben David, Yasmin Maor","doi":"10.1007/s10096-025-05212-7","DOIUrl":"10.1007/s10096-025-05212-7","url":null,"abstract":"<p><p>Murine typhus (MT), caused by Rickettsia typhi, is a zoonotic disease with a nonspecific clinical presentation, making diagnosis challenging. During 2022-2023, we observed in our hospital a rise in MT cases, prompting an investigation into clinical predictors and epidemiological factors, including potential links to a light rail system constructed in the hospital's vicinity. We conducted a retrospective case-control study of hospitalized febrile patients tested for rickettsial disease at the Wolfson Medical Center in central Israel (2022-2023). Cases were defined by positive R. typhi PCR or serology. Controls had negative testing for R. typhi (PCR and/or serology), with or without an alternative diagnosis, based on predefined criteria. Clinical, laboratory, and epidemiological data were analyzed, and residential proximity to the light rail construction site was assessed. Among 46 febrile patients tested for rickettsial disease, 18 were diagnosed with MT. Compared to controls, MT patients more frequently reported animal exposure and presented with headache, thrombocytopenia, bandemia, elevated liver enzymes, and increased LDH. Notably, MT patients lived significantly closer to the light rail system construction site than controls (mean 291.3 m vs. 836.2 m from the rail line, p = 0.022), with a 22% decrease in MT likelihood per additional 100 m distance. MT remains an important cause of febrile illness. Key diagnostic clues include animal exposure and specific laboratory markers. Our findings suggest an association between urban construction and MT, likely due to disrupted Rattus species habitats. Awareness of these risk factors may aid early diagnosis and treatment.</p>","PeriodicalId":11782,"journal":{"name":"European Journal of Clinical Microbiology & Infectious Diseases","volume":" ","pages":"2457-2464"},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}