Ginekologia polska最新文献

{"title":"Platelet to lymphocyte and neutrophil to lymphocyte ratios in endometrial pathologies.","authors":"Orkun Ilgen,&nbsp;Sefa Kurt,&nbsp;Resmiye Irmak Yuzuguldu,&nbsp;Onur Ada,&nbsp;Alper Mankan","doi":"10.5603/GP.a2021.0141","DOIUrl":"https://doi.org/10.5603/GP.a2021.0141","url":null,"abstract":"<p><strong>Objectives: </strong>Aim of this study was to evaluate the relationship between platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), and endometrial pathologies.</p><p><strong>Material and methods: </strong>The database of our institution was reviewed. Cases with endometrial pathology including endometrial cancer (EC), endometrial hyperplasia with atypia and without atypia, normal endometrial findings, between January 2015 to January 2020, were collected. Their CBC results and clinicopathologic data were determined. The relation between the platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and endometrial pathologies was evaluated.</p><p><strong>Results: </strong>NLR was significantly higher in patients with endometrial cancer compared to other endometrial pathologies including endometrial hyperplasia with and without atypia and patients with normal endometrial findings. NLR cut-off value was determined 3.55 to discriminate cancer among other endometrial pathologies. PLR had not a significant difference between the endometrial pathologies.</p><p><strong>Conclusion: </strong>NLR seems to be an effective and simple marker to discriminate endometrial cancer among endometrial pathologies by contrast with PLR.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":"94 4","pages":"269-274"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10215811","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 efficacy of thermocoagulation in women with biopsy-confirmed cervical low-grade squamous intraepithelial lesions (LSILs) or less after colposcopy referral.","authors":"Xiaoying Chen,&nbsp;Jian An,&nbsp;Jianfang Zhu","doi":"10.5603/GP.a2022.0055","DOIUrl":"https://doi.org/10.5603/GP.a2022.0055","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the clinical efficacy of thermocoagulation in women with biopsy-confirmed cervical low-grade squamous intraepithelial lesions (LSIL) or less after colposcopy referral.</p><p><strong>Material and methods: </strong>A longitudinal study was performed. Women who were diagnosed with cervical LSIL or chronic cervicitis underwent scheduled follow-up examinations with cytology and human papilloma virus (HPV) genotyping for two years after the initial management with thermocoagulation or observation without treatment. All women underwent scheduled follow-up with combined cytology and HPV test at 6th months, 12th months, and 24th months after the initial management. Both HPV clearance and cytological regression were included in the analysis, with clinical cure defined as normal cytology and negative HPV results.</p><p><strong>Results: </strong>A total of 221 women were included. The histopathological results identified 136 (61.54%) patients with LSIL and 85 (38.46%) with chronic cervicitis. Of these, 113 (51.13%) received thermocoagulation therapy, and 108 (48.87%) chose observation. The 2-year follow-up rate was 91.40%. Women who received thermocoagulation presented a significantly higher probability of cure for two years than those who chose observation (62.86% vs 39.18%, p < 0.001). This preponderance was not observed in the subgroup analysis regarding women with cervical cervicitis (54.17% vs 41.38%, p = 0.277) but was observed in women with LSILs (70.18% vs 38.24%, p < 0.001).</p><p><strong>Conclusions: </strong>Thermocoagulation may be indicated for patients with cervical LSILs as an effective outpatient procedure in clinical practice.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":"94 7","pages":"511-517"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10458122","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":"Prognostic significance of omental disease and the role of omentectomy in non-endometrioid endometrial cancer.","authors":"Sevtap Seyfettinoglu, Ghanim Khatib, Ümran Küçükgöz Güleç, Ahmet Barış Güzel, Derya Gümürdülü, Mehmet Ali Vardar","doi":"10.5603/gpl.92225","DOIUrl":"10.5603/gpl.92225","url":null,"abstract":"<p><strong>Objectives: </strong>Non-endometrioid endometrial cancers (non-EEC) have different management from endometrioid endometrial cancers. The purpose of this study was to investigate the prognostic significance of omental disease and the role of omentectomy in non-endometrioid endometrial cancer and discuss the current literature with the findings.</p><p><strong>Material and methods: </strong>The study included two hundred-three patients with non-EEC who underwent surgical treatment and follow-up between January 1996 and December 2018 in a University Hospital Gynecologic Oncology Center. The patients were divided into three groups according to whether omentectomy was performed and the presence of omental metastasis. The patient's demographics, clinical characteristics such as stage, grade, histopathologic type, lymphovascular space invasion (LVSI), myometrial invasion, lymph node involvement, and survival outcomes were compared between the groups.</p><p><strong>Results: </strong>The study included 203 patients. Twenty-five patients (12%) had omental metastases. LVSI was reported in 57.3%, 88.0%, and 43.2% of the non-omentectomy, no-omental metastasis, and omental metastatic groups, respectively (p = 0.001). The 5-year disease-free survival (DFS) and overall survival (OS) rates according to the tumor grade, peritoneal cytology, and lymphadenectomy were also compared and were found to be statistically similar. The five-year OS rates were 70.6% for the group without omental metastases and 16.2% for the group with omental metastases, respectively (p = 0.001). In the group of omentectomy, the five-year DFS rates were 62.2% in cases without omental metastasis and 13.0% in cases with omental metastasis (p = 0.001). The five-year OS rates of 86.3% and DFS rates of 80.0% in the group without omentectomy.</p><p><strong>Conclusions: </strong>In non-endometrioid tumors, the survival rate was better in the group that did not undergo omentectomy. Based on these results, we can say that omentectomy may not be necessary for non-endometrioid tumors whose omentum is found to be normal in intraoperative visual examination.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":"823-830"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031967","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":"SARS-CoV-2 infection during pregnancy - single-center retrospective study.","authors":"Malgorzata Skalska-Swistek, Magdalena Kolak, Andrzej P Jaworowski, Rafal Swistek, Agnieszka Micek, Hubert Huras","doi":"10.5603/gpl.95565","DOIUrl":"10.5603/gpl.95565","url":null,"abstract":"<p><strong>Objectives: </strong>The SARS-CoV-2 virus infection has spread to almost all countries in the last two years. Pregnancy complicated with COVID-19 is a unique situation and challenge for doctors. The study aimed to evaluate obstetric results, and biochemical test results and to analyze the treatment used in pregnant patients complicated with COVID-19 infection.</p><p><strong>Material and methods: </strong>A retrospective analysis of 146 pregnant patients hospitalized at the Department of Obstetrics and Perinatology Jagiellonian University Medical College (JUMC) in Krakow was conducted from July 2020 to August 2021.</p><p><strong>Results: </strong>In the analyzed group respiratory failure occurred in 19.19% of cases and intravascular coagulation syndrome (DIC) in 1.37%. One patient died (0.68%). 16.6% of cases were transferred to the Intensive Care Unit (ICU) and required intubation. The remaining cases were mild: 39.04% were asymptomatic, 41.78% reported cough, 30.82% dyspnoea and 23.97% myalgia. In the laboratory tests increased values of CRP and IL-6 were observed with normal levels of leukocytes. Additionally, a decreased level of total protein and an increased level of d-dimers were detected. 98.63% of patients received a prophylactic dose of low molecular weight heparin. 46.58% of cases needed additional antibiotic therapy. Cesarean sections were performed in 59.59% of cases. The children were born in good general condition. Vertical transmission of SARS-CoV-2 to the newborn has not been confirmed.</p><p><strong>Conclusions: </strong>Data from the above study show a significant effect of COVID-19 on pregnant patients. Almost one in five pregnant women occurred respiratory failure and most of them had to be transferred to the ICU department and had to be intubated.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":"831-838"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10031968","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":"It's high time to change our management of gestational diabetes.","authors":"Dorota A Bomba-Opon","doi":"10.5603/GP.a2023.0063","DOIUrl":"10.5603/GP.a2023.0063","url":null,"abstract":"","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":"94 6","pages":"427-428"},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9803557","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":"Perinatal and neonatal outcomes of adolescent pregnancies over a 10-year period.","authors":"Bahadir Yazicioglu,&nbsp;Nazan Yurtcu,&nbsp;Huri Guvey,&nbsp;Canan Soyer Caliskan,&nbsp;Samettin Celik,&nbsp;Andrea Tinelli","doi":"10.5603/GP.a2022.0085","DOIUrl":"https://doi.org/10.5603/GP.a2022.0085","url":null,"abstract":"<p><strong>Objectives: </strong>Poor overall neonatal outcomes, small neonatal head circumference, neonatal hypoglycemia, need for Neonatal Intensive Care Unit and late-onset neonatal sepsis are more common in adolescents. The aim of this study is to draw attention to the outcomes of adolescent pregnancies.</p><p><strong>Material and methods: </strong>This retrospective study was conducted in adolescent singleton pregnancies with maternal age < 15 years (n = 20, group 1), 16-19 years (n = 1929, group 2), and 20 years (n = 866, group 3). Age, gravidity, parity, and body mass index (BMI) measurements of mothers; mode of delivery, maternal and neonatal outcomes were evaluated and compared.</p><p><strong>Results: </strong>The rate of preterm birth, postpartum hemorrhage, asymmetrical intra-uterine growth restriction (IUGR, as 3% percentile), macrosomia, and height of newborn of Group 3 was significantly higher. The rate of asymmetrical IUGR (as 10% percentile) was significantly lower in Group 3. The rate of severe preeclampsia and cesarean section was significantly higher in Group 3. The rate of Small for Gestational Age newborn, neonatal hypoglycemia, and late-onset neonatal sepsis was significantly higher in Group 1.</p><p><strong>Conclusions: </strong>Neonatal problems with poor obstetric outcomes are common in adolescent pregnant women, so that a family planning and baby care social trainings are important in achieving good long-term maternal and neonatal outcomes.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":"94 6","pages":"500-506"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840538","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":"Endometrial carcinoma in patients under 40 years of age: insights from the Bulgarian Cancer Registry.","authors":"Angel Yordanov,&nbsp;Stoyan Kostov,&nbsp;Yavor Kornovski,&nbsp;Stanislav Slavchev,&nbsp;Yonka Ivanova,&nbsp;Jean Calleja-Agius,&nbsp;Riccardo Di Fiore,&nbsp;Sherif Suleiman,&nbsp;Andra Piciu,&nbsp;Ihsan Hasan,&nbsp;Mariela Vasileva-Slaveva","doi":"10.5603/GP.a2022.0106","DOIUrl":"https://doi.org/10.5603/GP.a2022.0106","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to investigate the overall survival (OS) of young women with endometrial cancer (EC) in Bulgaria and the impact of histological type on survival.</p><p><strong>Material and methods: </strong>This is a population-wide retrospective study of patients with EC (≤ 40 years at diagnosis) registered at Bulgarian National Cancer Registry (BNCR) between 1993 and 2020. Patients were re-classified according to the 8th edition of the TNM classification.</p><p><strong>Results: </strong>In total, 30 597 patients were registered and histologically confirmed with malignant tumors of the uterine body. From that, 29 065 of them (95%) had ECs, and the rest had sarcomas. Around 1.64% of all malignant tumors of the uterine body are diagnosed in women under the age of 40. Most of them are diagnosed in the early stage. There was no significant difference in median OS for patients diagnosed before or after 2003. In recent years there was a slight improvement in survival and patients from the last cohort of this study had a 5-year survival rate of 92.5%. Patients with favorable pathology (T1, G1/2) had no lymph node involvement at the time of diagnosis and their 10-year survival rate was 94%.</p><p><strong>Conclusions: </strong>EC in young women is a rare disease. In most cases, patients are diagnosed in early stageT1, G1/2, N0 and their prognosis is excellent. However, the lack of improvement of OS of young patients with EC in the last three decades shows the need for treatment optimization.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":"94 4","pages":"275-282"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9843503","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":"The importance of β-hCG values in prediction of the effectiveness of single dose methotrexate therapy in tubal ectopic pregnancy.","authors":"Askın Yıldız, Oznur Bilge","doi":"10.5603/GP.a2021.0247","DOIUrl":"10.5603/GP.a2021.0247","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the importance of β-hCG values on the day of onset and on the fourth and seventh day after treatment in the effectiveness of treatment in tubal ectopic pregnancies treated with a single dose of methotrexate (MTX).</p><p><strong>Material and methods: </strong>One hundred sixty-two patients with tubal ectopic pregnancy treated with a single dose MTX treatment were retrospectively evaluated. β-hCG values and changes on Days 0, 4 and 7 of the MTX treatment successful group and the unsuccessful group were analyzed.</p><p><strong>Results: </strong>MTX treatment was successful in 125 (77.2%) and unsuccessful in 37. When the β-hCG values on Days 0, 4 and 7 were compared in pairs, the differences between groups were statistically significant (p < 0.001). The mean β-hCG value was 783.0 in the MTX successful group and 1802.0 in unsuccessful group (p < 0.001). There was a 21.6% decrease in β-hCG values between Days 0 and day 4 in the MTX successful group and a 25.7% increase in the MTX unsuccessful group (p < 0.001). On Days 0, 4 and 7, ROC curve analysis's values are , respectively; 755/939/486 for cut off, 86.49/83.78/94.59% for sensitivity and 48.80/69.60/72.36% for specificity.</p><p><strong>Conclusions: </strong>Success rates of single-dose MTX treatment increase in tubal ectopic pregnancies with low initial β-hCG value. Patients with a decrease in β-hCG value and/or a cut-off decrease of 20% or more on the fourth day of treatment can be called for weekly β-hCG monitoring without the need for close follow-up. The change in β-hCG between Day 0 and Day 4 can be used to predict the efficacy of treatment.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":"94 4","pages":"303-308"},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110151","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":"Assessment of the birth status of children born by elective caesarean section before and after 39 weeks of gestation following <i>in vitro</i> fertilization.","authors":"Marek Pokulniewicz, Marcin Januszewski, Kamil Pluta, Alicja Jakimiuk, Tomasz Oleksik, Joanna Zytynska-Daniluk, Malgorzata Santor-Zaczynska, Artur Jakimiuk","doi":"10.5603/GP.a2022.0137","DOIUrl":"10.5603/GP.a2022.0137","url":null,"abstract":"<p><strong>Objectives: </strong>Planned delivery by elective cesarean section (ECS) currently takes place after the 39th week of pregnancy, in line with current common recommendations. This is related to studies finding an overall better birth condition of newborns in the general population, and especially regarding the maturation of the lungs. Currently, there are no specific recommendations regarding cesarean section and the timing of delivery in pregnancies resulting from in vitro fertilization.</p><p><strong>Material and methods: </strong>The collected material presents 512 mothers with children whose pregnancies were ended by caesarean section at the Department of Obstetrics, Women's Diseases and Oncological Gynecology Central Clinical Hospital of the Ministry of Internal Affairs in Warsaw in the years 2004-2016. The study group consisted of 362 mothers in pregnancies following in vitro fertilization and 150 mothers in spontaneous pregnancy, without the use of assisted reproductive technology. For the purposes of the project, only single pregnancies ending within weeks 37 to 41 of pregnancy were selected. For the purposes of our statistical and correlation analyses, having divided the pregnant women in our study group into four (elective CS delivery after IVF prior to 39 weeks, elective CS delivery after IVF after 39 weeks, elective CS delivery without the use of IVF after 39 weeks, and emergency CS delivery after IVF) we compared their data analysis of mothers and newborns results with time of delivery (weeks of gestation).</p><p><strong>Results: </strong>The aim of this study was to assess the optimal time of an elective cesarean section at full term in an IVF pregnancy. Consistent with findings in the general population and prevailing recommendations, the expected result would be the better condition of the baby born by ECS following the 39th week of gestation. However, our statistical analysis of the collected material shows that the group delivered by ECS prior to the end of 39 weeks of pregnancy may have fewer respiratory system interventions and higher Apgar scores. Nevertheless, results lack statistical significance.</p><p><strong>Conclusions: </strong>In conclusion these findings may indicate a need for a bigger database.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":"922-928"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10852358","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":"Development and validation of a performance assessment checklist for insertion of an intra-uterine device (IUD).","authors":"Stephanie Mignot, Anne-Charlotte Berthome, Marion Andre, Cyril Breque, Jean-Pierre Richer, Daniel Ghazali, Denis Oriot","doi":"10.5603/GP.a2023.0016","DOIUrl":"10.5603/GP.a2023.0016","url":null,"abstract":"<p><strong>Objectives: </strong>The World Health Organization (WHO) supports increasing the availability and acceptability of long-acting reversible contraception including intra-uterine device (IUD), but its insertion includes certain risks (uterine perforation). The objective was to develop and validate an IUD insertion performance assessment checklist.</p><p><strong>Material and methods: </strong>This prospective study took place in hospitals and simulation center of the Poitou-Charentes region, France. The checklist content reached consensus among 10 experts solicited by a Delphi method. A modified gynecologic mannequin Zoe (Gaumard®) was used for simulations. Psychometric testing included 30 multi-professional participants for internal consistency and reliability between two independent observers, and 27 residents for assessment of score evolution over time and reliability. Cronbach alpha (CA) and intraclass coefficient (ICC) were used. Progression of performance was carried out using ANOVA for repeated measures. The data collected were used to plot receiver operating characteristic (ROC) curves for the score values and the area under the curve (AUC) was determined.</p><p><strong>Results: </strong>The checklist included 27 items (2 sections, total score = 27). Psychometric testing showed CA = 0.79, ICC = 0.99, and good clinical relevance. The checklist is discriminative, showing a significant increase in performance scores when the simulations were repeated (F = 77.6, p < 0.0001). ROC curve [AUC: 0.792 (95% CI: 0.71-0.89); p < 0.0001] revealed the best score cutoff predictive of 100% sensitivity, i.e., true positive rate or success rate. Performance score was highly correlated to success rate. The cut-off score guaranteeing successful IUD insertion was 22/27.</p><p><strong>Conclusions: </strong>This coherent and reproducible checklist for IUD insertion provide an objective assessment of the procedure during SBT, with the aim of obtaining a score ≥ 22/27.</p>","PeriodicalId":12727,"journal":{"name":"Ginekologia polska","volume":" ","pages":"874-882"},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9277228","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}