Ginekologia polska最新文献

{"title":"Ductus venosus opens in high-risk pregnancies without signs of increased central venous pressure.","authors":"Marta I Sekielska-Domanowska,&nbsp;Anna Iwanicka-Piotrowska,&nbsp;Mariusz Dubiel,&nbsp;Rafal Adamczak,&nbsp;Natalia Lesiewska,&nbsp;Michal Koluda,&nbsp;Wojciech Cnota,&nbsp;Saemundur Gudmundsson","doi":"10.5603/GP.a2023.0061","DOIUrl":"https://doi.org/10.5603/GP.a2023.0061","url":null,"abstract":"<p><strong>Objectives: </strong>It has been belived that changes in diastolic blood velocities in the fetal ductus venosus were due to increased central venous pressure secondary to increased fetal heart strain during hypoxia or heart failure. There have been recent reports of changes in ductus venosus blood velocity without signs of increased fetal heart strain. The aim of this evaluation was to compare blood velocity in the right hepatic vein as a marker of increased central venous pressure in relationship to changes in ductus venosus blood velocity.</p><p><strong>Material and methods: </strong>Fifty pregnancies suspected of fetal growth resitriction were evaluated by Doppler ultrasound. Blood velocity was recorded in the right hepatic vein, ducus venosus and in the umbilical vein. Placental blood flow was also recorded in the uterine and umbilical arteries as well as the fetal middle cerebral artery.</p><p><strong>Results: </strong>Increased umbilical artery pulsatility index was recorded in 19 fetuses and 20 has signes of brain sparing according to recordings in the middle cerebral artery. Abnormal blood velocity in the ductus venosus was recorded in 5 fetuses, none of these fetuses had an abnormal pulsatility in the right hepatic vein.</p><p><strong>Conclusions: </strong>Opening of the ductus venosus is not only related to fetal cardiac strain. This might indicate that the ductus venosus does not primarily open due to increased central venous pressure in moderate fetal hypoxia. Increased fetal cardiac strain might be a late event in the process of chronic fetal hypoxia.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9761738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of dydrogesterone plus progesterone gel with subcutaneous aqueous progesterone plus progesterone gel for luteal phase supplementation of subsequent in vitro cycle in women after previous cycle failure.","authors":"Iwona M Gawron,&nbsp;Bartosz Chrostowski,&nbsp;Kamil Derbisz,&nbsp;Robert Jach,&nbsp;Milosz Pietrus","doi":"10.5603/GP.a2023.0062","DOIUrl":"https://doi.org/10.5603/GP.a2023.0062","url":null,"abstract":"<p><strong>Objectives: </strong>The luteal phase supplementation (LPS) of the in vitro fertilization (IVF) cycle is crucial to increase the chance of a live birth. There is no preferred progestogen for use in the general population. The optimal progestogen regimen in the event of prior IVF failure is unknown. The aim was to compare the live birth rate for dydrogesterone plus progesterone gel versus aqueous progesterone plus progesterone gel in LPS of the IVF cycle in women with at least one previous IVF failure.</p><p><strong>Material and methods: </strong>A prospective randomized single-center study enrolled women with at least one previous IVF failure undergoing another IVF cycle. Women were randomly assigned in a 1:1 ratio to 2 arms depending on LPS protocol: dydrogesterone (Duphaston®) + progesterone in vaginal gel (Crinone®) vs aqueous progesterone solution in subcutaneous injection (Prolutex®) + progesterone in vaginal gel (Crinone®). All women underwent fresh embryo transfer.</p><p><strong>Results: </strong>The live birth rate with one prior IVF failure was 26.9% for D + PG vs 21.2% for AP + PG (p = 0.54), and with at least two IVF failures: 16% for D + PG vs 31.1% for AP + PG (p = 0.16). There were no significant differences in live birth rates between protocols, regardless of the number of prior IVF failures.</p><p><strong>Conclusions: </strong>In light of the evidence from this study that neither of the two LPS protocols is more effective in women with prior IVF failure, other factors, such as potential side effects, dosing convenience and patient preference, should be considered when choosing a treatment.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9755822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterus sarcoma in 26-year-old patient with multiple uterine fibroids.","authors":"Marta Pajak,&nbsp;Slawomir Wozniak,&nbsp;Tomasz Paszkowski,&nbsp;Piotr R Szkodziak","doi":"10.5603/GP.a2023.0055","DOIUrl":"https://doi.org/10.5603/GP.a2023.0055","url":null,"abstract":"","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9630799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placenta accreta spectrum surgery with the Joel Cohen incision for abdominal access: a single-center experience.","authors":"Selim Buyukkurt,&nbsp;Mete Sucu,&nbsp;Irem Hatipoglu,&nbsp;Ferda Ozlu,&nbsp;Hakki Unlugenc,&nbsp;Cuneyt Evruke,&nbsp;Cansun Demir","doi":"10.5603/GP.a2023.0050","DOIUrl":"https://doi.org/10.5603/GP.a2023.0050","url":null,"abstract":"<p><strong>Objectives: </strong>Placenta accreta spectrum (PAS) is usually treated by hysterectomy performed through a midline incision. We hypothesize that PAS surgery can be performed through a Joel-Cohen incision with adequate sight and safety.</p><p><strong>Material and methods: </strong>The data on women having a hysterectomy due to PAS between 2013-2021 was collected retrospectively. Operation length, baby's pre-delivery general anesthesia exposure time, transfusion rates, complication rates, postoperative admission to the intensive care unit (ICU), postoperative hospital stay, and neonatal outcomes were collected. In addition, the data investigated whether the operation was performed under emergent conditions and in the early (2013-2016) or late (2017-2021) years.</p><p><strong>Results: </strong>161 patients met the inclusion criteria. The median gestational age at delivery was 34 weeks (27-39). The mean operation length was 150 minutes (75-420), and the anesthesia-to-delivery interval was 32 minutes (5-95). Twenty-three (14%) patients did not receive any blood product, 73 (45%) received less than three packs of erythrocyte, and only seven (4%) had a massive transfusion. Bladder injuries occurred in 24 (15%). Preoperative anemia, hypogastric artery ligation, transfusion, ICU admission, and maternal and neonatal complications were more frequent in emergent cases. Comparison between the early and late groups showed a decrease in the rate of anemia, maternal ICU admission, hypogastric artery ligation, and neonatal complications. In addition, infectious complications were relatively rare in all groups.</p><p><strong>Conclusions: </strong>The Joel-Cohen incision and bladder dissection before the baby's delivery reduce transfusion rates and avoid midline incision, which is prone to complications and unpleasant cosmetic appearance while performing a hysterectomy for PAS surgery.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9593824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk prediction of placenta previa based on the distance from the lower edge of the gestational sac to the internal cervical os in early pregnancy.","authors":"Yangyang Wang,&nbsp;Yujing Xu,&nbsp;Kai Sun,&nbsp;Wenjuan Gao,&nbsp;Yujian Lin,&nbsp;Zhenlan Wu","doi":"10.5603/GP.a2023.0033","DOIUrl":"https://doi.org/10.5603/GP.a2023.0033","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the relationship between the distance from the lower edge of the gestational sac to the internal cervical os in early pregnancy and placenta previa.</p><p><strong>Material and methods: </strong>A prospective cohort study of women who underwent pregnancy examination in Weifang People's Hospital or Sunshine Union Hospital from January 2020 to June 2021. The distance from the lower edge of the gestational sac to the internal cervical os was measured at 5-6 weeks' gestation. There were 86 women with distance < 2.5 cm, and 105 women with distance ≥ 2.5 cm were randomly selected. There were 92 cases of scarred uterus and 99 cases of non-scarred uterus among the 191 women. They were divided into six groups according to the distance: (1) < 1.0 cm; (2) 1.0 cm to < 1.5 cm; (3) 1.5 cm to < 2.0cm; (4) 2.0 cm to < 2.5 cm; (5) 2.5 cm to < 3.0 cm; (6) ≥ 3.0 cm. All included women were followed-up during pregnancy and pregnancy outcome, and the likelihood ratio of different distances in early pregnancy was calculated and risk stratification was performed, and ROC curve was constructed.</p><p><strong>Results: </strong>There were 15 women in the included studies who were lost to follow-up, 47 had a scarred uterus with placenta previa and 29 had a non-scarred uterus with placenta previa after delivery at 28 weeks or later. The distance from the lower edge of the gestational sac to the internal cervical os in early pregnancy of the scarred uterus < 1.5 cm, and the likelihood ratio was ∞; and the distance ≥ 3.0 cm, the likelihood ratio was 0. The distance from the lower edge of the non-scarred gestational sac to the internal cervical os < 1.0 cm, and the likelihood ratio was ∞; and the distance ≥ 3.0 cm, the likelihood ratio was 0. The ROC curve showed that when the area AUC under the curve was 87%, the optimal diagnostic cut-off value was 2.4 cm.</p><p><strong>Conclusions: </strong>When the distance from the lower edge of the gestational sac to the internal cervical os was < 1.5 cm and the distance between the non-scarred uterus was < 1.0 cm, it eventually developed into placenta previa; the distance from the lower edge of the gestational sac to the internal cervical os in the first trimester of pregnancy between the scarred uterus and the non-scarred uterus was ≥ 3.0 cm, and it would hardly develop into placenta previa. When the distance from the lower edge of the gestational sac to the internal cervical os in early pregnancy was ≤ 2.4 cm, it could be used as a predictor of placenta previa.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9791988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of gestational diabetes mellitus on outcomes of preinduced labour with dinoprostone vaginal insert.","authors":"Magdalena Kolak,&nbsp;Katarzyna Skibinska,&nbsp;Magda Rybak-Krzyszkowska,&nbsp;Agnieszka Micek,&nbsp;Tomasz Gora,&nbsp;Hubert Huras,&nbsp;Andrzej P Jaworowski","doi":"10.5603/GP.a2023.0030","DOIUrl":"https://doi.org/10.5603/GP.a2023.0030","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to evaluate the effectiveness of labour preinduction using a dinoprostone vaginal insert in patients with gestational diabetes mellitus versus patients undergoing labour induction for other causes. The second aim of the study was to compare perinatal outcomes in both groups.</p><p><strong>Material and methods: </strong>The study has a retrospective character, conducted in 2019-2021 in a tertiary reference hospital. The following endpoints were assumed for the analysis: natural childbirth, birth occurring within 12 hours of dinoprostone administration and neonatal outcomes. Furthermore, indications of a Caesarean section were analysed.</p><p><strong>Results: </strong>The percentage of natural childbirths was similar in both groups. Furthermore, in both groups, over 80% of patients gave birth within less than 12 hours following dinoprostone administration. Neonatal outcomes (body weight, Apgar score) did not differ statistically. Analysing indications for a Caesarean section, failure in the progress of labour was an indication in 39.5% of cases in the control group, 29.4% of cases in gestational diabetes mellitus (GDM), and 50% of cases in diabetes mellitus (DM). The risk of foetal asphyxia was an indication in 55.8% of cases in the control group, 35.3% of cases in GDM and 50% of cases in DM. Ineffective labour induction - no induction of the contractile function was an indication for a C-section in 4.7% of cases in the control group and 35.3% of cases in GDM; no cases were noted in DM (p = 0.024).</p><p><strong>Conclusions: </strong>The study demonstrated that patients undergoing labour induction due to GDM using a dinoprostone vaginal insert did not differ in terms of labour duration, oxytocin administration compared to patients undergoing labour induction for other causes. Furthermore, the same rate of Caesarean sections was found in the study group; however, these groups differ in terms of indications, including risk of foetal asphyxia (35.3% vs 55.8%), failure in the progress of labour (29.4% vs 39.5%), and no active labour (1.8% vs 1.5%). The neonatal Apgar score at 1.5 and 10 minutes after birth was similar in both groups.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9192562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical study on the effect of remifentanil patient-controlled intravenous labor analgesia compared to patient-controlled epidural labor analgesia.","authors":"Haibin Li,&nbsp;Hui Li,&nbsp;Yibing Yu,&nbsp;Yan Lu","doi":"10.5603/GP.a2023.0021","DOIUrl":"https://doi.org/10.5603/GP.a2023.0021","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the safety and efficacy of remifentanil for patient-controlled intravenous labor analgesia as an alternative to the patient-controlled epidural labor analgesia.</p><p><strong>Material and: </strong>METHODS: Out of 453 parturients who volunteered for labor analgesia and were selected as research objects, 407 completed the trial. They were divided into the research group (n = 148) and the control group (n = 259; patient-controlled epidural analgesia). In the research group, the first dose of remifentanil, the background dose and the patient-controlled analgesia (PCA) dose were 0.4 μg/kg, 0.04 μg/min and 0.4 μg/kg, respectively, with a lockout interval of 3 min. The control group was given epidural analgesia. The first dose and background dose were 6-8 mL, and PCA dose and the locking time of analgesia pump were 5 mL and 20 min, respectively. The following indexes of the two groups were observed and recorded: the analgesic and sedative effects on parturient, labor process, forceps delivery, cesarean section rate and adverse reactions, and maternal and neonatal conditions.</p><p><strong>Results: </strong>1. The onset time of analgesia in the research group was (0.97 ± 0.08) min, which was noticeably shorter than that in the control group ([15.74 ± 1.91] min), with a statistically significant difference (t = -93.979, p = 0.000). 2. There was no significant difference in the labor process, forceps delivery, cesarean section rate and neonatal condition between the two groups (p > 0.05).</p><p><strong>Conclusions: </strong>Remifentanil patient-controlled intravenous labor analgesia has the advantage of rapid onset of labor analgesia. Although its analgesic effect is not as accurate and stable as epidural patient-controlled labor analgesia, it shows a high level of maternal and family satisfaction.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9192564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lactoferrin supplementation during pregnancy - a review of the literature and current recommendations.","authors":"Paulina Gawel,&nbsp;Barbara Krolak-Olejnik","doi":"10.5603/GP.a2023.0020","DOIUrl":"https://doi.org/10.5603/GP.a2023.0020","url":null,"abstract":"<p><p>Pregnancy is a period which requires special care and attention. Maintaining health during pregnancy helps to avoid birth related complications and is the best way of promoting a healthy birth. Besides a daily intake of folic acid, iron, iodine, vitamin D3 and A, calcium and polyunsaturated fatty-acids, as recommended by health agencies, supplementation of lactoferrin - a protein of multidirectional biological activity and proven safety of use - seems to be beneficial. A wide range of lactoferrin biological roles (including regulation of iron balance, modulation of immune responses, antimicrobial, antiviral, antioxidant, and anti-inflammatory activity) may contribute to better pregnancy and birth related outcomes.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9492538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could pelvic floor sonography be a standalone method for excluding genuine stress urinary incontinence in women?","authors":"Mariusz Malmur,&nbsp;Jakub Mlodawski,&nbsp;Marta Mlodawska,&nbsp;Marcin Misiek,&nbsp;Olga Adamczyk-Gruszka,&nbsp;Piotr Niziurski,&nbsp;Stanislaw Gluszek,&nbsp;Wojciech Rokita","doi":"10.5603/GP.a2023.0026","DOIUrl":"https://doi.org/10.5603/GP.a2023.0026","url":null,"abstract":"<p><strong>Objectives: </strong>Determine whether introital pelvic floor sonography with transvaginal probe (PFS-TV) can be an independent method in the diagnosis of genuine stress urinary incontinence (SUI) and to create a ultrasonographic diagnostic model to objectify diagnostic process.</p><p><strong>Material and methods: </strong>The study involved 315 patients with a history of urinary incontinence problems. Based on the clinical examination and urodynamic examination, the final diagnosis was made. Patients were divided into two groups. Group I included women with SUI and Group II included patients without SUI (OAB and no-UI). Each patient underwent PFS-TV at rest and during straining. The groups were compared in terms of ultrasound parameters.</p><p><strong>Results: </strong>Patients from both groups differed statistically in a significant way (p < 0.05) in terms of mean distance between the lower edge of the pubic symphysis at rest 19 mm vs 22 mm (Group I vs Group II) and during straining (D1 and D2) 22 mm vs 26 mm, the average value of the γ angle (at rest (γ1) 37.5° vs 40° and during straining (γ2) and 66° vs 58.5°, average difference value of angle γ during straining and at rest (γ2-γ1) 29° vs 14°, and frequency of urethral funneling 89% vs 17%. Two parameters studied during PFS-TV were included in the logistic regression model used to exclude the stress component of urinary incontinence. Diagnostic test parameters of model were sensitivity 86.6%, specificity 90.4%, accuracy 93.1%.</p><p><strong>Conclusions: </strong>PFS-TV makes it possible to exclude the stress component of urinary incontinence. The developed logistic regression model allows for the objectification of the results of ultrasound examination in patients with urinary incontinence.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9121322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does body mass index affect anti-mullerian hormone levels in girls and adolescents?","authors":"Iwona Czech,&nbsp;Mirosław Partyka,&nbsp;Agnieszka Drosdzol-Cop","doi":"10.5603/GP.a2023.0013","DOIUrl":"https://doi.org/10.5603/GP.a2023.0013","url":null,"abstract":"<p><p>Anti-mullerian hormone (AMH) is a dimeric glycoprotein which belongs to the transforming growth factor-beta superfamily. In women, it is produced by granulosa cells in pre-antral and small antral follicles. In recent years, there has been a continuous increase in obesity among children and adolescents. There are few studies that present AMH concentrations in premenarcheal and early postmenarcheal girls. The purpose of this work is to assess whether AMH levels were associated with body mass index (BMI) in adolescent girls before and after menarche. The study was performed at the Pediatric Endocrinology Department and Outpatient Clinic at Upper Silesian Child Health Center. 82 girls were enrolled to the study. Body mass index seems not to affect the AMH levels in adolescents, however a special attention must be given when interpreting AMH levels in girls with irregular menstrual cycles and observed for PCOS.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9121327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}