European journal of preventive cardiology最新文献

{"title":"Visceral Adipose Tissue, Aortic Distensibility and Atherosclerotic Cardiovascular Risk Across Body Mass Index Categories.","authors":"Umidakhon Makhmudova, Benjamin Wild, Alice Williamson, Elisabeth Steinhagen-Thiessen, Claudia Langenberg, Roland Eils, Ulf Landmesser, Anna Sannino","doi":"10.1093/eurjpc/zwaf447","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf447","url":null,"abstract":"<p><strong>Background: </strong>While obesity is a well-established risk factor for cardiovascular disease, the relationship between visceral obesity, as assessed by imaging modalities of visceral adipose tissue (VAT), and the risk of atherosclerotic cardiovascular disease (ASCVD) has been insufficiently explored in large-scale studies, particularly across different body mass index (BMI) categories.</p><p><strong>Aim: </strong>We aimed at investigating the association between VAT and aortic distensibility as well as risk of ASCVD and comparing the magnitude of VAT-aortic distensibility and VAT-ASCVD association across BMI groups.</p><p><strong>Methods: </strong>Leveraging data from the UK Biobank, we examined the association between body weight-normalized VAT (VAT-index, VATi), assessed via abdominal MRI (VATi-MRI) or dual-energy X-ray absorptiometry (DXA; VATi-DXA), and aortic distensibility (a direct local measure of aortic stiffness) as well as the risk of atherosclerotic cardiovascular disease (ASCVD) over a median follow-up period of 4.7 years.</p><p><strong>Results: </strong>The abdominal MRI sub-cohort of the UK Biobank included 36829 individuals, among which 28888 individuals were additionally evaluated using DXA. VATi was associated with decrease in ascending aortic distensibility (VATi-MRI adjusted β = -0.05 (95% CI -0.07 to -0.04, p<0.001); VATi-DXA adjusted b = -0.04 (95% CI -0.06 to -0.03, p<0.001) and increased risk of ASCVD (VATi-MRI: HR 1.16 (95% CI 1.09-1.23, p<0.001); VATi-DXA: 1.21 (95% CI 1.13-1.3), p<0.001), adjusted for age, sex, socioeconomic status, lifestyle factors, and cardiometabolic comorbidities. Across BMI categories, these associations were more pronounced in non-obese individuals. The cumulative incidence of ASCVD was higher in individuals with high VATi compared to those with low VATi, consistently observed across BMI categories. With a total of 1,462 ASCVD events, incidence rates were higher in individuals with high VATi compared to low VATi across all BMI categories: 5.5% vs. 2.2% in the normal BMI group, 5.7% vs. 2.5% in the overweight group, and 5.9% vs. 2.1% in the obese group (p log-rank <0.001). Overall, in the multivariable-adjusted Cox proportional hazard model, VATi was associated with 16% increased ASCVD risk (HR 1.16 [95% CI 1.09-1.23], p<0.001), but this association was attenuated when adjusted for the clinical marker of central obesity, the waist-to-hip ratio (WHR). In contrast, the association remained significant in the normal BMI group even after adjusting for WHR (HR for VATi-MRI 1.22 (95 % CI 1.06-1.42, p<0.01; VATi-DXA 1.35 (95% CI 1.11-1.65, p<0.01).</p><p><strong>Conclusions: </strong>Visceral obesity, measured by advanced imaging modalities, is linked to greater aortic stiffness and elevated risk of ASCVD, independent of BMI, in individuals without known ASCVD. Notably, these associations were observed mostly in non-obese subjects, with the strongest associations found in the normal BMI gro","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663885","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":"Effective implementation of preventive cardiology guidelines: pathways to success.","authors":"Izabella Uchmanowicz, Michał Czapla, Katarzyna Lomper, Paolo Iovino, Marta Rosiek-Biegus, Stanisław Surma, Kazem Rahimi","doi":"10.1093/eurjpc/zwaf448","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf448","url":null,"abstract":"<p><p>This review highlights the importance of implementing preventive cardiology guidelines-both for primary and secondary prevention-to improve patient outcomes and reduce the burden of cardiovascular disease. Despite the availability of comprehensive guidelines, adherence remains suboptimal, resulting in a persistent gap between evidence-based recommendations and real-world clinical practice. To address this, we conducted a narrative review of studies published between January 2010 and March 2024 using PubMed, Scopus, and Web of Science. Studies were included if they focused on the implementation of cardiology guidelines and identified either barriers or facilitators to adherence. The synthesis of findings was structured using the Consolidated Framework for Implementation Research (CFIR), which organizes implementation factors into five domains: intervention characteristics, outer setting, inner setting, characteristics of individuals, and implementation process. Key strategies identified include continuous education and training for healthcare providers, integration of guidelines into clinical workflows through Clinical Decision Support Systems (CDSS), and strengthening of organizational infrastructure. Simplifying guidelines to increase usability and fostering patient engagement via educational interventions and digital tools were also emphasized. By aligning identified barriers with evidence-based solutions through the CFIR framework, this review provides a structured and practical roadmap for enhancing guideline adherence. Ultimately, these strategies aim to bridge the evidence-practice gap in preventive cardiology, enhancing the effectiveness, equity, and consistency of both primary and secondary cardiovascular prevention efforts.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663884","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":"Association between the Life's Essential 8 Health Behaviors and Prognosis in Patients with Advanced Cardiovascular-Kidney-Metabolic Syndrome.","authors":"Siyuan Tan, Jiabao Zhou, Fanqi Li, Gaoming Zeng, Na Liu, Tao Tu, Hao Chen, Qiuzhen Lin, Qiming Liu","doi":"10.1093/eurjpc/zwaf443","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf443","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the association between the Life's Essential 8 (LE8) and mortality risk in patients with advanced cardiovascular-kidney-metabolic (CKM) syndrome, focusing on the prognostic impact of its health behavior and health factor components.</p><p><strong>Method: </strong>A total of 10,321 participants were included from the NHANES. Kaplan-Meier curve and Cox proportional-hazards models, and restricted cubic splines (RCS) were used to assess the associations of LE8, health behaviors, and health factors with mortality risk.</p><p><strong>Result: </strong>Among all participants, 2629 had advanced CKM syndrome. Over a median 78-month follow-up, 579 deaths occurred. Each 10-point increase in the LE8 score reduced advanced CKM syndrome risk by 15% (OR = 0.85), while low CVH increased risk by 105% (OR = 2.05). Advanced CKM syndrome was associated with higher mortality risks, while each 10-point increase in the LE8 score reduced mortality risk. However, no significant difference in mortality risk was observed between the moderate and high CVH groups. Notably, each 10-point increase in the health behavior score lowered all-cause (HR = 0.80), cardiovascular (HR = 0.83), and CKM-related mortality risk (HR = 0.82), while patients with moderate (HR = 2.08, 1.88, 1.94) and low CVH (HR = 3.25, 253, 2.89) faced higher mortality risks. In contrast, the health factor showed no significant association with mortality risk.</p><p><strong>Conclusion: </strong>The LE8, particularly its health behavior, is independently associated with mortality in advanced CKM syndrome. These findings suggest that LE8-based behavioral interventions could potentially reduce risk in advanced CKM syndrome patients.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658787","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":"Association of health knowledge with adoption of heart healthy behaviours: a cross-cohort analysis using data from the PURE Study.","authors":"Shiva Raj Mishra, Richard Lindley, Angela Webster, Patricio Lopez-Jaramillo, Rosnah Ismail, Jayachitra Krishnaswamy Gajendran, Indu Mohan, Rekha M Ravindran, Manmeet Kaur, Christina E Lundberg, Karen Yeates, Khalid F Alhabib, Roya Kelishadi, Katarzyna Zatonska, Homer U Co, Scott A Lear, Karen Suarez, Iolanthé M Kruger, Pamela Serón, Maria Luz Diaz, Yilin Huang, Zhiguang Liu, Yingxuan Zhu, Alvaro Avezum, Afzalhussein Yusufali, Rita Yusuf, Jephat Chifamba, Ahmet Temizhan, Romaina Iqbal, Sumathy Rangarajan, Martin McKee, Salim Yusuf, Clara K Chow","doi":"10.1093/eurjpc/zwaf428","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf428","url":null,"abstract":"<p><strong>Aims: </strong>This study aims to assess aspects of health knowledge: i) awareness of health effect of tobacco smoking and ii) awareness of preventive actions for heart disease and stroke, and their relationships with adoption of heart healthy behaviours (smoking cessation and utilisation of antihypertensive treatment).</p><p><strong>Methods: </strong>In this multi-cohort study, we recruited adults aged 35 to 70 years from 21 countries. Data on health effects of tobacco smoking (10 questions) and health actions to prevent heart disease or stroke (11 questions) were collected at baseline. Logistic regression analyses were used to examine the relationship with the outcomes of smoking cessation and use of antihypertensive treatment adjusting for adjusting for possible confounders.</p><p><strong>Results: </strong>Of the 12,962 included in the descriptive analysis, 50.0% were female, 42.9% had no or primary education, and 53.3 % were residing in low or lower middle-income country. Among current and former smokers, having knowledge of health effect of tobacco smoking on heart disease [Adjusted Odds Ratio (aOR): 1.70, 95% CI: 1.19, 2.43)], stroke (1.41, 1.08,1.86), and on heart disease in non-smokers exposed to others smoking (1.40, 1.06,1.86) were significantly and positively associated with smoking cessation compared to those who were not aware of health effects. Knowledge of the importance of reducing dietary salt aOR 1.62 (1.23,2.13), dietary fat aOR 1.56 (1.17,2.08) and exercising more aOR 1.48 (1.22,1.80) to prevent heart disease or stroke were positively associated with taking anti-hypertensive medication compared to those who were not aware of preventative actions.</p><p><strong>Conclusion: </strong>This study reinforces that better health knowledge shapes adoption of heart healthy behaviours such as smoking cessation and taking anti-hypertensive treatment even after accounting for baseline education and wealth.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658788","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":"Authors' Reply.","authors":"Douglas Mesadri Gewehr, Alleh Nogueira, Emilton Lima Junior","doi":"10.1093/eurjpc/zwaf446","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf446","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658789","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":"Genetic interleukin-6 receptor blockade, Chronic Disease Risk and Longevity. Results from the Women's Health Initiative.","authors":"Stephanie Wissel, Kathleen M Hovey, Chris A Andrews, Connor R Miller, Aladdin H Shadyab, Robert B Wallace, Su Yon Jung, Rami Nassir, Charles Eaton, Marcia Stefanick, Andrea LaCroix, JoAnn E Manson, Sylvia Wassertheil-Smoller, Michael J LaMonte, Bernhard Haring","doi":"10.1093/eurjpc/zwaf444","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf444","url":null,"abstract":"<p><strong>Background: </strong>Interleukin-6 (IL-6) levels have been related to increased risk of chronic disease and mortality. Whether genetic IL-6 receptor (IL6R) blockade is associated with lower chronic disease risk or greater longevity is unknown.</p><p><strong>Methods: </strong>The analytic cohort consisted of 38,807 Women's Health Initiative participants that had available genotyping information, of which 23,464 were eligible to survive to 90 years of age through February 19, 2023. Carrier status of the IL6R variant (rs8192284; p.Asp358Ala) was determined via genotyping. Chronic disease outcome data were available through February 19, 2023 for coronary heart disease (CHD), heart failure (HF), stroke and invasive cancer events. Prospective associations of IL6R carrier status with chronic disease outcomes were assessed with the Cox proportional hazards models, and logistic regression was used to evaluate survival to 90 years of age during follow-up.</p><p><strong>Results: </strong>During a median follow-up of 20 years, 12,181 of 23,464 women (52.0%) survived to age 90. No significant difference in likelihood of surviving to age 90 was detected between women with 2 alleles of the IL6R gene variant compared to women without any allele (Odds Ratio, 1.00; 95% confidence interval, 0.91-1.09). The risks of CHD, HF, stroke, or cancer did not differ among IL6R variant carriers. High-sensitive C-reactive Protein (hsCRP) levels ≥2 mg/L compared to <2mg/L were associated with a modest increase in all-cause mortality and CHD risk independent of IL6R allele carrier status.</p><p><strong>Conclusion: </strong>Genetic IL6R blockade was not associated with incident chronic disease risk including invasive cancer and longevity in a large, ethnically diverse cohort of postmenopausal women. No significant interaction with hsCRP levels was observed. While pharmacological blockade of IL6R has become a major therapeutic strategy in the treatment of immune-mediated inflammatory disease, these long-term data on genetic IL6R blockade do not indicate an altered likelihood for survival to very old age.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658790","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":"Reply: Challenges in Defining, Measuring, and Calculating Remnant Cholesterol.","authors":"Shoaib Afzal, Julie Riis, Børge G Nordestgaard","doi":"10.1093/eurjpc/zwaf449","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf449","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658792","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":"Accelerometer-measured circadian alignment predicts all-cause and cardiovascular mortality in middle-aged and older adults.","authors":"Jiarong Xie, Tianchen Qian, Pengyao Lin, Hui Gao, Chengfu Xu, Lei Xu","doi":"10.1093/eurjpc/zwaf445","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf445","url":null,"abstract":"<p><strong>Aims: </strong>Circadian alignment plays a key role in cardiometabolic regulation. We examined whether accelerometer-derived alignment metrics independently predict all-cause and cardiovascular mortality in middle-aged and older adults.</p><p><strong>Methods: </strong>We included 4,814 U.S. adults aged ≥45 years from the 2011-2014 NHANES cycles. Circadian alignment was measured once for each participant during their examination year via wrist-worn accelerometer data. Two phasor metrics-magnitude (synchronization strength) and angle (timing deviation)-were categorized into quartiles. Mortality was ascertained through linkage to the National Death Index, with follow-up through December 31, 2019. All-cause and cardiovascular disease (CVD)-specific mortality rates were analyzed via weighted Cox proportional hazards regression, Fine and Gray's competing risk models, and restricted cubic splines to account for nonlinear associations.</p><p><strong>Results: </strong>Over 31,280 person-years, 736 deaths occurred (235 CVD-related deaths). Compared with those in the highest quartile (Q4), participants in the lowest quartile of phasor magnitude (Q1) had a significantly greater risk of all-cause mortality (HR, 1.70; 95% CI, 1.08-2.68). A U-shaped association was observed for the phasor angle: both advanced (Q1) and most delayed (Q4) timing were linked to elevated all-cause mortality risk, with Q2 representing optimal alignment. For CVD-specific mortality, advanced timing (Q1 vs. Q2) was associated with a 68% increased risk (HR, 1.68; 95% CI, 1.09-2.60). Restricted cubic splines confirmed nonlinear relationships.</p><p><strong>Conclusions: </strong>A lower phasor magnitude and both advanced and delayed phasor angles were associated with higher all-cause and CVD-specific mortality. Circadian metrics may serve as biomarkers to inform wearable-based monitoring and behavioral interventions.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658786","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":"Implementation of prevention guidelines in primary healthcare: a scientific statement of the European Association of Preventive Cardiology of the ESC, the ESC Council for Cardiology Practice, the Association of Cardiovascular Nursing & Allied Professions of the ESC, WONCA Europe, and EURIPA.","authors":"Donata Kurpas, Ferdinando Petrazzuoli, Eduard Shantsila, Maria Antonopoulou, Ruxandra Christodorescu, Oleksii Korzh, Thomas Kümler, Martha Kyriakou, Lis Neubeck, Panteleimon E Papakonstantinou, Dimitri Richter, Anne Grete Semb, Manuel Frias Vargas, Marc Ferrini","doi":"10.1093/eurjpc/zwaf384","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf384","url":null,"abstract":"<p><p>This scientific statement explores the challenges and opportunities associated with implementing cardiovascular disease (CVD) prevention guidelines in primary healthcare across Europe. It identifies key barriers to adherence, including limited resources, diagnostic complexity, and inconsistencies in care delivery. Emphasis is placed on the use of practical tools such as risk assessment instruments, shared decision-making, and integrated information technology systems to support effective implementation. Particular focus is given to vulnerable populations, including individuals with multi-morbidity, to promote equitable access to prevention and care. As CVD remains the leading global cause of death, a proactive and structured preventive approach in primary care is essential to reduce its burden. Evidence-based interventions-including health monitoring, lifestyle counselling, and pharmacotherapy-play a central role in improving outcomes. While patients at high cardiovascular risk are a major focus, strategies for those at lower risk but without established disease are also needed. Promoting long-term adherence to healthy behaviours from early stages may significantly delay disease onset. However, many patients in Europe still fail to meet key prevention targets, such as optimal levels of cholesterol, blood pressure, and glucose control. Variability in implementation across regions, especially in lower-income countries, underscores the need for practical, user-friendly, and context-adapted guidelines. Coordinated care models involving multiple disciplines and sectors, supported by leadership and digital tools, are critical. The statement also highlights three specific areas of interest for improving CVD prevention in primary care: chronic venous disease, lipoprotein(a) management, and cardiovascular risk in patients with inflammatory rheumatic diseases.</p>","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648903","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":"Cracking the Code: T-Wave Inversion as a Gatekeeper for Sudden Cardiac Death Prevention.","authors":"Sabiha Gati, Nirmitha Jayaratne","doi":"10.1093/eurjpc/zwaf395","DOIUrl":"https://doi.org/10.1093/eurjpc/zwaf395","url":null,"abstract":"","PeriodicalId":12051,"journal":{"name":"European journal of preventive cardiology","volume":" ","pages":""},"PeriodicalIF":8.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642069","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}