Heart, Lung and Circulation最新文献

{"title":"Intravascular Haemolysis and Acute Kidney Injury Following Pulsed Field Ablation: A Systematic Review and Meta-Analysis.","authors":"Pirel Aulia Baravia, Amir Aziz Alkatiri, Bernadus Bernardino Bramantyo, Ganiera Putri Barabanuas Nurfairudz, Dicky Armein Hanafy, Isman Firdaus","doi":"10.1016/j.hlc.2026.04.117","DOIUrl":"https://doi.org/10.1016/j.hlc.2026.04.117","url":null,"abstract":"<p><strong>Background & aims: </strong>Despite atrial fibrillation ablation showing promise, recent studies have described the potential induction of haemolysis and onset of acute kidney injury (AKI) caused by pulsed field ablation (PFA) raising safety concerns. This study aimed to evaluate the changes in haemolysis and renal function biomarker following the ablation.</p><p><strong>Methods: </strong>We systematically searched PubMed, ScienceDirect, and Cochrane Library for observational and randomised controlled trials up to 16 July 2025. We calculated the changes using the difference between pre- and post-ablation biomarker levels. Generic inverse variance was used with 95% confidence interval (CI). Data measures were mean difference (MD) and pooled using a random effects model.</p><p><strong>Results: </strong>Ten observational studies with 1,292 patients were included. PFA is associated with haemolysis reflected on significant increase in lactate dehydrogenase (MD -123.63, 95% CI -194.54 to -52.71), bilirubin (MD -0.82, 95% CI -1.44 to -0.20), and free plasma haemoglobin (MD -47.50, 95% CI -62.36 to -32.65) together with a reduction of haptoglobin (MD 0.58, 95% CI 0.23 - 0.94) following the ablation resulting reduced red blood cell (MD 0.19, 95% CI 0.03 to 0.35), haemoglobin (MD 0.99, 95% CI 0.62 to 1.36), and haematocrit (MD 2.79, 95% CI 1.10 to 4.49). However, there were no difference in urea (MD -0.20, 95% CI -1.17 to 0.77), creatinine (MD -0.07, 95% CI -0.14 to 0.00), and estimated glomerular filtration rate (MD -2.63, 95% CI -6.65 to 1.39).</p><p><strong>Conclusions: </strong>Despite significant haemolysis-related biomarker changes after PFA, no clinically meaningful anaemia occurred, and AKI was rare and transient. Renal risk appears to depend on application and baseline renal vulnerability, while post-ablation hydration may serve as a preventive strategy against AKI. Further optimisation of PFA and peri-procedural management is needed to enhance safety.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911824","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":"Transradial Access-Induced Injury During Invasive Coronary Angiography: A Histological Analysis to Guide Radial Protection for Conduit Use.","authors":"Garry W Hamilton, Christopher B Freelance, Jessica Beechey, Gregory King, Anees Enayati, Varun J Sharma, Siven Seevanayagam, Jay Bhaskar, David L Hare, Jaishankar Raman, Omar Farouque","doi":"10.1016/j.hlc.2026.04.126","DOIUrl":"https://doi.org/10.1016/j.hlc.2026.04.126","url":null,"abstract":"<p><strong>Background: </strong>Transradial access (TRA) for invasive coronary angiography (ICA) can injure the radial artery (RA). We investigated the distribution of injury to propose injury-mitigation strategies to maximise RA conduit availability for coronary artery bypass grafting (CABG).</p><p><strong>Method: </strong>This was a single-centre study including 24 patients who underwent CABG with both the left and right RA after TRA for ICA. Four tissue samples were acquired from each patient: the proximal (subjected to wires and catheters during the ICA) and distal (subjected to the sheath during ICA) instrumented and non-instrumented RAs. Histological analyses assessed regional differences in injury to the instrumented as compared to the non-instrumented RA.</p><p><strong>Results: </strong>The distal instrumented RA intima-to-media ratio was higher compared to both the proximal instrumented RA (p=0.009) and the proximal non-instrumented RA (p=0.005). No difference was seen in the density of fibrosis in the media (beta regression: χ²=3.459; p=0.33). There were no statistically significant differences in the presence or absence of inflammation, fibrosis, intimal thickening, calcification, disruption or duplication of the internal elastic lamina, or intimal injury and erosion (Pearson's chi-squared: χ²=10.572, df=15; p=0.78). Visual inspection of the correlation plot of the residuals suggested a higher-than-expected count of inflammation in the instrumented RA, and a higher-than-expected rate of fibrosis in the proximal instrumented RA.</p><p><strong>Conclusions: </strong>Instrumented RA conduit deemed suitable for grafting has histological changes induced by TRA. Although the injury pattern varies, the intima-to-media ratio differences suggest intimal proliferation is greatest in the sheath-exposed distal RA, while the qualitative findings suggest reactive changes are more apparent in the instrumented RA as a whole. The findings suggest the smallest possible sheath and catheters should be considered during ICA, particularly in patients with a high index of suspicion of needing CABG, to help maximise RA conduit availability.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911837","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":"Post-TAVR LVOTO: Contemporary Management and Clinical Outcomes.","authors":"Newton N Le, Nicholas Fanous, Rita-Marie Abdo, Kiersten A Liddy, Mayooran Namasivayam, David Muller","doi":"10.1016/j.hlc.2026.04.124","DOIUrl":"https://doi.org/10.1016/j.hlc.2026.04.124","url":null,"abstract":"<p><p>Transcatheter aortic valve replacement (TAVR) is an established therapy for severe aortic stenosis, yet dynamic left ventricular outflow tract obstruction (LVOTO) remains an uncommon but critical complication. We reviewed published reports of LVOTO after TAVR to delineate clinical patterns, imaging features, and management strategies. LVOTO may be pre-existing and worsen with TAVR or arise de novo after relief of valvular afterload. Emerging data suggests that septal hypertrophy, small left ventricular cavity size, and adverse mitral-septal geometry may identify patients at risk. Management is individualised and includes medical optimisation, atrioventricular pacing, alcohol septal ablation, and transcatheter edge-to-edge mitral repair. An imaging-guided approach may support earlier recognition, risk stratification and management of this rare but severe post-TAVR complication.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911819","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":"Limus-Coated Balloon Versus Paclitaxel-Coated Balloon for Percutaneous Coronary Intervention: Updated Systematic Review and Meta-Analysis.","authors":"Pirel Aulia Baravia, Amir Aziz Alkatiri, Doni Firman, Arwin Saleh Mangkuanom, Nanda Iryuza, Hana Soraya, Ganiera Putri Barabanuas Nurfairudz, Bernadus Bernardino Bramantyo, Dicky Armein Hanafy, Isman Firdaus","doi":"10.1016/j.hlc.2026.03.076","DOIUrl":"https://doi.org/10.1016/j.hlc.2026.03.076","url":null,"abstract":"<p><strong>Background & aims: </strong>Although previous meta-analyses have compared limus-based coated balloons (LCB) and paclitaxel-coated balloons (PCB), an updated evaluation of safety and efficacy is needed due to recent randomised controlled trials (RCTs). We aimed to re-evaluate the safety and efficacy of LCB and PCB.</p><p><strong>Methods: </strong>We conducted a systematic search of randomised controlled trials (RCTs) up to October 2025. The primary outcome was target lesion revascularisation (TLR); secondary outcomes included clinical and angiographic endpoints. Pooled relative risk (RR) and mean difference (MD) with 95% confidence intervals (CI) were calculated using random-effects models.</p><p><strong>Results: </strong>Ten RCTs with 1,463 patients and 1,434 lesions were included in the analysis. LCB was comparable with PCB in TLR (RR 1.14; 0.83-1.58; p=0.42), major adverse cardiovascular events (RR 0.98; 95% CI 0.64-1.48; p=0.91), myocardial infarction (RR 1.22; 95% CI 0.47-3.17; p=0.69), all-cause mortality (RR 1.04; 95% CI 0.40-2.70; p=0.94), cardiac death (RR 0.73; 95% CI 0.17-3.22; p=0.68), and target vessel myocardial infarction (RR 0.71; 95% CI 0.28-1.84; p=0.49). Angiographic follow-up showed comparable results between LCB and PCB evaluated from binary restenosis (RR 1.33; 95% CI 0.87-2.05; p=0.19), late lumen loss (MD 0.10; 95% CI -0.00 to 0.21; p=0.05), diameter stenosis (MD 2.94; 95% CI -0.81 to 6.69; p=0.12), minimal lumen diameter (MD -0.09; 95% CI -0.18 to 0.05; p=0.30).</p><p><strong>Conclusions: </strong>In the pooled RCT data to 12 months, we found no statistically significant differences between LCB and PCB for major clinical endpoints. However, angiographic endpoints show borderline differences (late lumen loss) and numerically higher binary restenosis with LCB; device heterogeneity and limited follow-up mean that firm equivalence regarding angiographic endpoints should be interpreted with caution.</p>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887115","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 a Digital Prehabilitation Solution Informed by Evidence-Based Interventions Reduce the Healthcare Burden and Improve Outcomes for Patients Awaiting Cardiac Surgery?—A Systematic Review","authors":"Claire Hines MPhysio,&nbsp;Joshua Farragher PhD,&nbsp;Ross Vlahos PhD,&nbsp;Linda Denehy PhD,&nbsp;Louise Doull MHealthServMg,&nbsp;Doa El-Ansary PhD","doi":"10.1016/j.hlc.2026.02.023","DOIUrl":"10.1016/j.hlc.2026.02.023","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Prehabilitation before cardiac surgery targets modifiable risk factors to enhance surgical readiness and recovery. It can reduce complications, mortality, and hospital stay; however, remains underused in routine cardiac care. As digital health gains traction, remote delivery of prehabilitation offers a promising way to expand access and equity to cardiac patients. This review examines the delivery, outcomes, and effectiveness of digital prehabilitation for adults awaiting cardiac surgery.</div></div><div><h3>Method</h3><div>This review followed the Preferred Reporting Items of Systematic Reviews and Meta-Analyses Analyses 2020 guidelines and was registered with PROSPERO (ID: 452250). Seven databases were searched, identifying studies which evaluated digital prehabilitation in cardiac surgery patients. Screening, selection, and data extraction were performed, and outcomes were categorised by feasibility, health outcomes, and healthcare utilisation.</div></div><div><h3>Results</h3><div>Analysis showed significant findings in favour of digital prehabilitation over standard care in terms of feasibility, efficacy, complications, and costs/healthcare utilisation. Interrogation of the results data via meta-analysis was unsuitable due to the heterogeneity of the methodologies and evaluation time points.</div></div><div><h3>Conclusions</h3><div>Digital prehabilitation is a safe, feasible and potentially effective strategy to improve outcomes and reduce healthcare burden in cardiac surgery.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages 1224-1244"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Streamlining Transcatheter Aortic Valve Implantation: Lessons From Minimalist Pathways and Heart-Team Reform","authors":"Ashish H. Shah MD, MD-Research, FRCP(UK)","doi":"10.1016/j.hlc.2026.01.014","DOIUrl":"10.1016/j.hlc.2026.01.014","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages e129-e130"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148029772","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":"Health Care Workers’ Preferences in the Delivery of Atrial Fibrillation Screening: A Systematic Review","authors":"Ureni Halahakone MHM, MD,&nbsp;Samantha J. Borg BHSC(Nut&Diet),&nbsp;Sameera Senanayake MSc, PhD,&nbsp;Victoria McCreanor MSc, PhD,&nbsp;William Parsonage FRACP, DM,&nbsp;David Brain MPH, PhD","doi":"10.1016/j.hlc.2026.03.056","DOIUrl":"10.1016/j.hlc.2026.03.056","url":null,"abstract":"<div><h3>Background</h3><div>Health care workers (HCWs) play a crucial role in the success of atrial fibrillation (AF) screening programs. However, screening for AF remains underused due to organisational barriers, such as time constraints, user knowledge of the intervention, workforce constraints and turnover and availability of resources. Therefore, it is important to understand the preferences of HCWs on how to best integrate AF screening in routine practice.</div></div><div><h3>Method</h3><div>Five databases were systematically searched for studies that reported on HCWs’ opinions, thoughts, and preferences of screening published between January 2013, and August 2023 were included. An updated search was conducted in July 2025. An inductive thematic analysis was conducted, supported by a convergent qualitative–quantitative synthesis. Study quality was assessed using the mixed-methods appraisal tool.</div></div><div><h3>Results</h3><div>Twenty-six studies met the inclusion criteria. Most studies were AF-focused with Australia having the highest representation of studies. Two overarching themes were identified: (1) screening preferences (device, frequency of screening, and population) and (2) implementation of screening into practice (change management, governance, communication, costs, and infrastructure). While HCWs broadly supported electrocardiogram-based screening tools and integration into existing workflows, preferences varied across professional groups and settings, particularly regarding role expansion, remuneration, and organisational readiness.</div></div><div><h3>Conclusions</h3><div>HCWs broadly support AF screening, but differ in expectations regarding delivery roles, resources, and system readiness. Aligning AF screening programs with workforce preferences and organisational capacity is essential for scalable and sustainable implementation.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages 1245-1258"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Drug Access in Australia and New Zealand: New PBS and PHARMAC Listings, 2023–2025","authors":"Jonathan L. Ciofani MPH, MD,&nbsp;Rajesh Puranik MBBS, PhD,&nbsp;Avedis Ekmejian MBBS, PhD,&nbsp;Usaid K. Allahwala MBBS, PhD,&nbsp;Shreyans Sinhal,&nbsp;Julianne James-Smith MEngSc,&nbsp;Salvatore Pepe PhD,&nbsp;Mayanna Lund MBChB,&nbsp;Ravinay Bhindi MBBS, PhD","doi":"10.1016/j.hlc.2026.06.001","DOIUrl":"10.1016/j.hlc.2026.06.001","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease is a leading cause of death in Australia and New Zealand. Publicly subsidised access to new cardiovascular medications is governed by the PBS (Pharmaceutical Benefits Scheme) in Australia and PHARMAC (Pharmaceutical Management Agency) in New Zealand, yet no consolidated resource catalogues recent listings across both jurisdictions.</div></div><div><h3>Methods</h3><div>We reviewed all new cardiovascular drug listings and indications on the PBS and PHARMAC schedules from 1 January 2023 to 31 December 2025. PBS data were obtained from the PBS Pricing and Policy Branch through the Cardiac Society for Australia and New Zealand. PHARMAC data were obtained via direct communication with PHARMAC and cross-referenced with public schedule information. Pivotal trial evidence, restriction criteria, and prescribing considerations were extracted from published literature and regulatory documents.</div></div><div><h3>Results</h3><div>Five new cardiovascular drugs were PBS-listed (inclisiran, mavacamten, tafamidis, icosapent ethyl and migalastat), two existing drugs received new cardiovascular indications (empagliflozin and dapagliflozin for heart failure with preserved ejection fraction) and prasugrel was relisted for acute coronary syndrome. One major change occurred on the PHARMAC schedule (empagliflozin for heart failure with reduced ejection fraction).</div></div><div><h3>Conclusions</h3><div>The 2023–2025 period has seen notable additions to cardiovascular pharmacotherapy in Australia, including the first cardiac myosin inhibitor, the first transthyretin stabiliser, expanded lipid lowering therapy options, and extension of SGLT2 inhibitor coverage across the heart failure ejection fraction spectrum. A pronounced access disparity persists between Australia and New Zealand.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages 1193-1202"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Acute Coronary Occlusion—The Malignant STEMI Mimic","authors":"Jeet Upadhyay MD,&nbsp;Shaun Khanna MBBS, MMed,&nbsp;Aditya Bhat MBBS, MPH, DDU,&nbsp;Suzanne Eshoo MBBS, PhD","doi":"10.1016/j.hlc.2026.01.016","DOIUrl":"10.1016/j.hlc.2026.01.016","url":null,"abstract":"","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages e125-e127"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148054173","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":"Perspectives on Advance Care Planning in Adult Congenital Heart Disease: An Australian Sample","authors":"Pasangi Madhuka Wijayarathne MD,&nbsp;Samuel Menahem MD, DMedHSc","doi":"10.1016/j.hlc.2025.12.030","DOIUrl":"10.1016/j.hlc.2025.12.030","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with adult congenital heart disease (ACHD) now survive well into adulthood though their overall long-term survival remains below the general population. Advance care planning (ACP) has been endorsed by clinical guidelines, yet it is infrequently discussed and/or implemented.</div></div><div><h3>Methods</h3><div>As part of an international multicentre APPROACH-IS II study, 184 consecutive ACHD patients completed a questionnaire regarding their perceptions on the future and ACP.</div></div><div><h3>Results</h3><div>There were 88 males and 96 females in the study. The mean age was 29.4±8.94 years. The mean score for future health concern was 5.83±2.55, (0=no concerns, 10=extreme concern). Concern regarding future health was associated with NYHA Class (p&lt;0.001), the average score of concern increasing with increasing NYHA Class. Forty-five percent of participants were aware of processes around advance care directives and plans, but only 4% had documented their wishes. There was no association between documentation and concerns regarding future health, or NYHA class. Sixty-nine percent of patients agreed that ACP should occur when patients are well. However, only 51% of patients had discussed their future health with their clinicians. Only 8% and 24% of patients were uncomfortable discussing their future health and death respectively. No information was obtained about how comfortable the cardiologists were about discussing ACP.</div></div><div><h3>Conclusions</h3><div>There is limited understanding of ACP among ACHD patients. Although most patients accept the value of ACP early in the patient’s clinical course, few in this Australian sample documented their end-of-life care wishes. Further education of both ACHD patients and their attending clinicians toward initiating these sensitive discussions of ACP may lead to more patients documenting their wishes.</div></div>","PeriodicalId":13000,"journal":{"name":"Heart, Lung and Circulation","volume":"35 9","pages":"Pages 1357-1365"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}