Haemophilia最新文献

{"title":"A qualitative study on the perioperative experiences and demands of haemophilic arthropathy patients undergoing total joint replacement","authors":"Qian Su,&nbsp;Yashuang Shao,&nbsp;Yunchun Bao,&nbsp;Yanan Kan,&nbsp;Bainv Wu,&nbsp;Fuying Ye","doi":"10.1111/hae.15073","DOIUrl":"10.1111/hae.15073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Total joint replacement is the optimal treatment option for patients with severe haemophilic arthritis. Current research emphasizes patient-reported outcomes as a vital measure for evaluating surgical outcomes and patient satisfaction. Nevertheless, very limited information about the subjective experience of perioperative haemophiliacs in the literature, highlighting the need for exploration in this area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To investigate the psychological experiences and health demands of haemophilic arthropathy patients during the perioperative period of total joint replacement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Qualitative descriptive research with semistructured individual interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From June to September 2023, nine patients with severe haemophilic arthropathy who underwent total joint replacement at a Haemophilia Diagnosis and Treatment Centre in China were interviewed for average 37 min per person. Data were analysed using the traditional content analysis method and reported following the consolidated criteria for reporting qualitative research. The study is reported according to the COREQ checklist.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Interviews described two main themes: (1) emotional decline which involves preoperative overoptimism, early postoperative anxiety and disease uncertainty during the early independent rehabilitation. (2) wellness aspiration which includes rehabilitation support and spiritual healing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study reveals the patients’ significant psychological changes and their well-being aspiration, particularly out-of-hospital rehabilitation needs. Strengthening communication between multidisciplinary teams and patients, enhancing the involvement of nurses, broadening the scope of functions at primary Haemophilia Treatment Centres, and developing telerehabilitation, these concerted efforts may improve the overall treatment experience for patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"30 4","pages":"1050-1058"},"PeriodicalIF":3.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456324","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":"Identifying hemophilia B carriers: Utility of aPTT, factor IX levels and ratios of factor IX to other Vitamin K dependent factors","authors":"Michael Shu,&nbsp;Caroline Malcolmson,&nbsp;Alessandra Bosch,&nbsp;Teodora Markovic,&nbsp;Cindy Wakefield,&nbsp;Vanessa Bouskill,&nbsp;Manuel Carcao","doi":"10.1111/hae.15068","DOIUrl":"10.1111/hae.15068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Diagnosing hemophilia B (HB) carrier status is important to manage bleeding in carriers and to prevent bleeding in potential offspring. Without a family history of hemophilia, diagnosing HB carrier status is challenging. Genetic testing is the gold-standard, however it is reserved for individuals with a high suspicion of carrier status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To describe the distribution of activated partial thromboplastin time (aPTT) and factor IX coagulant (FIX:C) levels in HB carriers and assess the ratio of FIX:C to other Vitamin K dependent factors (FII:C, FVII:C, FX:C) as an indicator of HB carrier status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective, single-centre cohort study, subjects were included if they were obligate or genetically proven HB carriers. Distributions of aPTT and FIX:C were described and the relationship between FIX:C levels in carriers and severity of familial HB was analysed. Ratios of FIX:C to FII:C, FVII:C, FX:C were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-two female HB carriers (median age: 34 years; IQR 24–43) were included. Median aPTT and FIX:C levels were 33.0 s [IQR 30.0–37.0] and 57 IU/dL [IQR 43–74]. Fifteen carriers (21%) had mild HB (FIX:C levels of 10–40 IU/dL). FIX:C levels trended higher in carriers of mild HB versus carriers of moderate/severe HB. In six carriers, the median ratio of FIX:C to other Vitamin K dependent factors was 0.44, with 92% of ratios being ≤ 0.75.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>aPTT and FIX:C levels were unreliable in diagnosing HB carrier status. A low ratio of FIX:C to other Vitamin K dependent factors may be a useful marker of HB carrier status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"30 4","pages":"1003-1009"},"PeriodicalIF":3.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hae.15068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emicizumab plasma levels after accelerated saturation in acquired haemophilia A","authors":"Tristan Kloeter,&nbsp;Maren Keller,&nbsp;Michael Metze,&nbsp;Sirak Petros,&nbsp;Christian Pfrepper","doi":"10.1111/hae.15069","DOIUrl":"10.1111/hae.15069","url":null,"abstract":"","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"30 5","pages":"1227-1229"},"PeriodicalIF":3.0,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456325","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":"Accuracy and clinical role of digital templating for total knee arthroplasty performed on haemophilic knees","authors":"Arman Vahabi,&nbsp;Erdem Er,&nbsp;Elcil Kaya Biçer,&nbsp;Fahri Şahin,&nbsp;Kaan Kavakli,&nbsp;Semih Aydoğdu","doi":"10.1111/hae.15072","DOIUrl":"10.1111/hae.15072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In total knee arthroplasty (TKA), choosing the correct implant size is important. There is lack of data on accuracy of templating on haemophilic knees. Our aim was to test the accuracy of 2D digital templating for TKA on haemophilic arthropathy (HA) of knee.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>TKAs performed on HA between January 2011 and January 2022 were screened. Osteoarthritis (OA) group was created as control group by a one-to-one matching regarding type of implant used. Intra- and interobserver correlations were measured in HA, then correlation between templated and implanted sizes was investigated in four assessments (femur AP, femur lateral, tibia AP, tibia lateral), then compared with OA group. Fifty-eight knees in each group included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Regarding intraobserver correlation in HA, there was excellent correlation for femur AP [.93 (.73–.98)], femur lateral [.98 (.91–.99)], and tibia AP (1.0) templating. Regarding interobserver correlation in HA, excellent correlation was observed for femur lateral [.93 (.74–.98)] and tibia AP templating [.90 (.65–.97)]. Regarding correlation of templated and applied sizes in HA; tibia AP, tibia lateral and femur lateral templating showed good correlation [.81 (.70–.89), .86 (.77–.91), .79 (.67–.87) while femur AP templating showed moderate correlation [.67 (.50–.79)]. Comparing HA and OA, there was no difference in correlation levels regarding femur AP, femur lateral, tibia AP and tibia lateral templating (<i>p</i> = .056, <i>p</i> = .781, <i>p</i> = .761, <i>p</i> = .083, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although 2D digital templating shows comparable correlation in HA and OA, clinical applicability of templating on HA appears to be limited in its current state.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"30 4","pages":"1043-1049"},"PeriodicalIF":3.0,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hae.15072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141506954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world experience of rIX-FP prophylaxis at dosing intervals of 14 days or more in adult patients with haemophilia B in Italy – Results from IDEAL Part B","authors":"Antonio Coppola,&nbsp;Flora Peyvandi,&nbsp;Laura Banov,&nbsp;Dorina Cultrera,&nbsp;Maurizio Margaglione,&nbsp;Alberto Tosetto,&nbsp;Lelia Valdrè,&nbsp;Irene Schiavetti,&nbsp;Anna Loraschi,&nbsp;Giancarlo Castaman,&nbsp;Ideal Study Group","doi":"10.1111/hae.15074","DOIUrl":"10.1111/hae.15074","url":null,"abstract":"&lt;p&gt;Recombinant factor IX-albumin fusion protein (rIX-FP, Albutrepenonacog alfa) is an extended half-life factor IX (FIX) with approximately 5-fold longer half-life compared to standard half-life (SHL) FIX and provides excellent bleeding prevention with a great flexibility in dosing intervals.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; rIX-FP is approved for the treatment of persons with haemophilia B (PWHB) at dosing intervals of 7 days in &lt;12 years, up to 14 days in ≥12 years and, in selected adults, up to 21 days.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; However, available real-world evidence about prophylaxis regimen ≥14 days is limited. The observational study IDEAL (IDelvion in hEmophilia B: evaluAtion of posoLogic profile) described pattern of use and outcomes of rIX-FP prophylaxis in the clinical practice in moderate/severe PWHB (FIX ≤ 5%). The first phase (Part A) involved 23 Italian hemophilia treating centers (HTC) enrolling from October 2017 to February 2019 59 PWHB of all ages with a 2-year follow-up observation.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Herein, we present the subsequent phase of the study, Part B, specifically aimed at gathering real-world experience on adult PWHB on prophylaxis regimen with dosing intervals ≥14 days.&lt;/p&gt;&lt;p&gt;IDEAL Part B prospectively (1-year follow-up, 1YFU) collected, from April 2021 to December 2022, data about PWHB ≥18 years on dosing regimen ≥ 14 days at baseline, treated with rIX-FP ≥6 months, either previously involved in the Part A or not. The study was approved by the ethics committee at each participating centre and conducted in accordance with good clinical practice and local regulatory requirements. All patients provided written informed consent. Primary endpoints (EP) were infusion frequency, annualized number of infusions, FIX annualized consumption. Secondary EP included FIX trough levels (when measured), Annualized Bleeding Rate (ABR), rIX-FP haemostatic efficacy, presence of target joints (i.e., occurrence of ≥3 spontaneous bleeds into a single joint within a consecutive 6-month period&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;), chronic synovitis—assessed through physical examination (World Federation of Haemophilia, WFH, Orthopaedic Joint Score&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt;) and, when available, ultrasound scanning according to the HEAD-US (Haemophilia Early Arthropathy Detection with Ultrasound&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;) protocol—chronic joint pain, physical activity, tolerability, and immunogenicity. Previous FIX data were retrospectively gathered (from Part A, or &lt;i&gt;de novo&lt;/i&gt;, for new patients) and compared to rIX-FP at 1YFU. Patients were asked to fill in an infusion diary throughout the observational period including information on date, duration of each infusion, IU infused, reasons for infusion and site of bleeding, if any; each bleeding event reported in the patient diary was confirmed after discussion with the treating physician. According to physical activity, patients were considered as “sedentary” in case of no activity performed at all, “","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"30 4","pages":"1067-1070"},"PeriodicalIF":3.0,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hae.15074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of bruising and joint hypermobility: The need to consider genetic testing for platelet disorders","authors":"Divyaswathi Citla-Sridhar,&nbsp;Jared Canonigo,&nbsp;Shelley E. Crary","doi":"10.1111/hae.15066","DOIUrl":"10.1111/hae.15066","url":null,"abstract":"","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"30 5","pages":"1225-1226"},"PeriodicalIF":3.0,"publicationDate":"2024-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330775","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":"Reduced doses of emicizumab achieve good efficacy: Results from a national-wide multicentre real-world study in China","authors":"Yuan Xu,&nbsp;Ying Wang,&nbsp;Runhui Wu,&nbsp;Changcheng Zheng,&nbsp;Li Zhang,&nbsp;Weiqun Xu,&nbsp;Xiaoqin Feng,&nbsp;Hua Wang,&nbsp;Xiangshan Cao,&nbsp;Liya He,&nbsp;Tianyang Xue,&nbsp;Mingwei Jin,&nbsp;Bingshou Xie,&nbsp;Jing Ling,&nbsp;Lirong Sun,&nbsp;Rui Su,&nbsp;Hongbo Cheng,&nbsp;Yongjun Fang,&nbsp;Man-Chiu Poon,&nbsp;Wei Liu,&nbsp;Lei Zhang,&nbsp;Feng Xue,&nbsp;Renchi Yang","doi":"10.1111/hae.15062","DOIUrl":"10.1111/hae.15062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Reduced doses of emicizumab improve the affordability among patients in developing countries. However, the relationship between variant dose selection and efficacy in the real world of China is still unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to investigate the efficacy and safety of emicizumab especially in those on reduced dose regimens in a real-world setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We carried out a multicentre study from 28 hospitals between June 2019 and June 2023 in China and retrospectively analysed the characteristics including demographics, diagnosis, treatment, bleeding episodes, and surgical procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 127 patients with haemophilia A, including 42 with inhibitors, were followed for a median duration of 16.0 (IQR: 9.0–30.0) months. Median age at emicizumab initiation was 2.0 (IQR: 1.0–4.0) years. Median (IQR) consumption for loading and maintenance was 12.0 (8.0–12.0) and 4.2 (3.0–6.0) mg/kg/4 weeks, respectively. While on emicizumab, 67 (52.8%) patients had no bleeds, whereas 60 (47.2%) patients had any bleeds, including 26 with treated bleeds. Compared to previous treatments, patients on emicizumab had significantly decreased annualized bleeding rate, annualized joint bleeding rate, target joints and intracerebral haemorrhage. Different dosages had similar efficacy except the proportion of patients with treated spontaneous bleeds and target joints. Adverse events were reported in 12 (9.4%) patients. Postoperative excessive bleeding occurred following two of nine procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the largest study describing patients with HA receiving emicizumab prophylaxis on variant dose regimens in China. We confirmed that nonstandard dose is efficacious and can be considered where full-dose emicizumab is ill affordable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"30 4","pages":"959-969"},"PeriodicalIF":3.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hae.15062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the kinematic analysis of indoor and outdoor gait in people with haemophilia and total knee replacement","authors":"Carlos Cruz-Montecinos,&nbsp;Christ Devia,&nbsp;Maximiliano Barahona,&nbsp;Hachi Manzur,&nbsp;Jorge Toledo","doi":"10.1111/hae.15061","DOIUrl":"10.1111/hae.15061","url":null,"abstract":"","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"30 4","pages":"1102-1104"},"PeriodicalIF":3.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141295932","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":"Low bleeding rates after intramuscular Covid-19 vaccination in patients with haemophilia and von Willebrand disease: Outcome data from the Swedish haemophilia registry","authors":"Nadine G. Andersson,&nbsp;Hannes Brange,&nbsp;Jan Astermark,&nbsp;Malin Axelsson,&nbsp;Fariba Baghaei,&nbsp;Maria Magnusson,&nbsp;Anna Olsson,&nbsp;Elsa Olsson,&nbsp;Susanna Ranta,&nbsp;Linda Myrin Westesson,&nbsp;Margareta Holmström","doi":"10.1111/hae.15063","DOIUrl":"10.1111/hae.15063","url":null,"abstract":"","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"30 5","pages":"1217-1220"},"PeriodicalIF":3.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hae.15063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of one-stage and chromogenic assays for the laboratory measurement of factor VIII activity following valoctocogene roxaparvovec infusion","authors":"Sean Platton,&nbsp;Priyanka Raheja,&nbsp;Christopher Dale,&nbsp;Susan Guy,&nbsp;Nada Yartey,&nbsp;Annette Bowyer","doi":"10.1111/hae.15064","DOIUrl":"10.1111/hae.15064","url":null,"abstract":"","PeriodicalId":12819,"journal":{"name":"Haemophilia","volume":"30 5","pages":"1221-1224"},"PeriodicalIF":3.0,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hae.15064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}