Indian Journal of Medical Research最新文献

{"title":"A mobile based antimicrobial susceptibility testing device - prototype development and validation.","authors":"Anu Aravindh, Akanksha Gupta, Manodeep Sen, Anupam Das, Jyotsna Agarwal","doi":"10.25259/IJMR_214_2026","DOIUrl":"10.25259/IJMR_214_2026","url":null,"abstract":"<p><p>Background and objectives Antimicrobial resistance is a major concern due to multidrug-resistant pathogens. Advances in smartphone technology provide opportunity to digitise antimicrobial susceptibility testing (AST). This study aimed to develop and validate an in-house semi-automated smartphone application (app) for the measurement and interpretation of AST. Methods In this prospective validation study, an in-house app was developed using an AI-assisted coding workflow. The app uses a digital calibration algorithm that correlates pixel dimensions with millimetres (mm). AST was performed using the Kirby-Bauer disk diffusion method (KBDD) on Escherichia coli (n=48), and Staphylococcus aureus (n=15) and zone diameters were measured manually, interpreted using Clinical and Laboratory Standards Institute (CLSI) followed by analysis of the same plates using the app. S. aureus (14 drugs) required at least two Mueller-Hinton agar (MHA) plates per isolate, while E. coli (22 drugs) required at least three MHA plates per isolate. Results AST was performed on 1,000 antibiotic disks. Zone diameters were measured and interpreted by both methods. Categorical agreement was 90.4%. Unweighted Cohen's Kappa was 0.836 (95% CI: 0.806-0.866). Categorical discrepancies occurred in 96 antibiotic disks. Very major, major, and minor error rates were 0%, 0.83%, and 9.2%, respectively. Interpretation and conclusions The app demonstrated reliable interpretation of AST, with high categorical agreement and less than 1% major error rates, supporting its safety for resistance detection. This approach offers a user-friendly alternative for busy, resource-limited settings that can be used routinely.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 2","pages":"220-226"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678450","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":"Epigenetic reprogramming by BCG (Bacillus Calmette-Guérin) vaccination: A novel strategy to reverse immunodeficiency in chronic kidney disease.","authors":"Rohit Sharma, Krishna Tiwari, Muhammad Aaqib Shamim, Surjit Singh, Pradeep Dwivedi, Rajesh Jhorawat, Shoban Babu Varthya","doi":"10.25259/IJMR_131_2026","DOIUrl":"10.25259/IJMR_131_2026","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is associated with reflecting innate immune impairment. Chronic inflammation, oxidative stress, metabolic dysregulation, and prolonged uraemia are the primary causes of this condition. Monocytes, macrophages, and their progenitors may undergo drastic epigenetic changes in response to these systemic stresses. This has lowered the activation of histone marks, such as H3K4me3, and destabilised repressive marks, like H3K9me3. Critical immune response genes are silenced by chromatin closure. This epigenetic change exhausts the immune system and impairs its ability to clear pathogens. This causes 'uraemic immunodeficiency', a poor vaccination response, and increased susceptibility to infection. On the other hand, the Bacillus Calmette-Guérin (BCG) vaccination may produce trained immunity, a favourable innate immunological memory. BCG stimulates the NOD2 and Akt/mTOR pathways. This increases H3K4me3 near cytokine gene promoters and stabilises H3K9me3 in non-essential genomic areas. This progressive remodelling creates transcriptionally permissive chromatin that increases inflammatory reactivity. This increases the phagocytosis and antimicrobial activity of monocytes, macrophages, and neutrophils. BCG also reprogrammes hematopoietic stem and progenitor cells to create sustained myeloid cells. Comparing CKD-induced immunological paralysis to BCG-induced immune extension indicates that metabolic and environmental factors strongly influence the innate immune epigenome. BCG-induced trained immunity may represent a low-cost, host-directed strategy to reduce infection susceptibility and improve vaccine responsiveness in patients with CKD. This review shows that the BCG restores chromatin accessibility and transcriptional ability to treat CKD-induced immunological deficiencies. To restore immunological function in CKD patients, BCG-based therapies and epigenetic modulators should be studied.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 4","pages":"511-521"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135881","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":"Azithromycin minimum inhibitory concentration (MIC) creep and clinical-microbiological profile of typhoidal and nontyphoidal Salmonella isolates from blood specimens at a tertiary care hospital in Pune, India.","authors":"Sumit Sonaba Chavan, Kalpana Mohan Angadi, Varsha Shahane, Satyanand Kadloor","doi":"10.25259/IJMR_1311_2025","DOIUrl":"10.25259/IJMR_1311_2025","url":null,"abstract":"<p><p>Background and objectives The Salmonella strains causing bloodstream infection show wide genetic diversity together with different antibiotic resistance profiles worldwide. The response of typhoidal Salmonella to standard antimicrobial treatments has become increasingly concerning during the past few decades. This study was conducted to evaluate the occurrence rate, antibiotic susceptibility patterns, and clinical characteristics of patients with Salmonella bacteraemia in a tertiary care hospital in Pune, Maharashtra, India. Methods A cross-sectional study was conducted from March 2024 to March 2025, analysing blood culture-confirmed cases of enteric fever. All patients with Salmonella-positive cultures were included, and data were gathered from clinical and microbiology records. Results Out of 6,862 blood cultures processed, 42 (0.6%) tested positive for Salmonella species. Of these, 50% were Salmonella Typhi, 36% were Salmonella Paratyphi A, and the remaining 14% included S. Cholerasuis, S. Typhimurium, and S. Gallinarum. All S. Typhi and S. Paratyphi A isolates were fully susceptible to first-line antibiotics, including chloramphenicol, amoxicillin, and co-trimoxazole, as well as to ceftriaxone and cefixime. However, 78.5% of isolates showed reduced susceptibility to ciprofloxacin. Initial disc diffusion testing suggested potential azithromycin resistance in 11 isolates, but confirmatory E-strip testing found none to be resistant based on MIC values. One S. Paratyphi A isolate exhibited a notably high MIC of 24 µg/mL, which is not classified as resistant according to U.S. NARMS guidelines. Interpretation and conclusions The increasing azithromycin MIC values among typhoidal Salmonella indicate potential resistance development, so additional research should assess azithromycin susceptibility patterns in detail.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 4","pages":"630-636"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136451","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":"Dyanopenia dependent muscle wasting in elderly.","authors":"Josef Finsterer","doi":"10.25259/IJMR_366_2026","DOIUrl":"10.25259/IJMR_366_2026","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 4","pages":"663-664"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136462","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":"Protective antibody response following two doses of measles vaccination and factors for non-response among children from tribal Odisha, India.","authors":"Bhagirathi Dwibedi, Gayatri Patra, Abhilipsa Behera, Harpreet Kaur, Rojalini Tarai","doi":"10.25259/IJMR_3672_2025","DOIUrl":"10.25259/IJMR_3672_2025","url":null,"abstract":"<p><p>Background and objectives Globally, measles cases remain above 10 million despite the introduction of two dose measles vaccination schedule since 2000. India reported 13220 cases during 2023-2024, ranking fourth globally. This raises concern regarding the effectiveness of the ongoing programme to achieve measles elimination. Tribal dominated regions in countries such as India needs particular attention due to their higher burden of childhood morbidity and mortality. This study aimed to estimate the proportion of children developing protective antibody levels following two doses of measles vaccine in a tribal location and to identify potential risk factors associated with non-response. Methods A tribal dominated region, the undivided Phulbani district of Odisha, India, was randomly selected. Using cluster sampling, 1375 Infants aged 8 months were enrolled from 30 tribal habitations and followed to document vaccination status. Blood samples (n=1185) were collected three months after the second measles vaccine dose, and their measles IgG antibody levels were quantified. Variables likely to influence antibody response were recorded and statistically evaluated. Results Two-dose measles vaccine coverage was 99.6%; however, 55.1% (n=653) of children demonstrated seropositivity (IgG titre ≥ 250 IU/L). Male gender was significantly associated with suboptimal antibody response. Age, nutritional status, interval between first and second vaccine doses, and vaccination logistics were not found to influence antibody response. Interpretation and conclusion This study provides the first evidence of suboptimal measles antibody response among children from a tribal area of Odisha, India, despite high vaccination coverage. There is a need to understand the immune persistence among such a vulnerable population, where measles control remains a challenge.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 2","pages":"311-315"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678560","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":"Microalbuminuria in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis.","authors":"Andrea Erlac, Jesus Diez-Manglano","doi":"10.25259/IJMR_238_2026","DOIUrl":"10.25259/IJMR_238_2026","url":null,"abstract":"<p><p>Background and objectives We conducted this systematic review and meta-analysis to determine the prevalence of microalbuminuria in patients with chronic obstructive pulmonary disease (COPD) and its association with COPD severity. Methods We conducted a literature search in PubMed, Embase, Scopus, Web of Science, Cochrane Library, and the Virtual Health Library from inception to December 31th, 2024. The search strategy was: ('chronic obstructive pulmonary disease' OR COPD OR 'chronic airflow obstruction' OR emphysema OR 'chronic bronchitis') AND (microalbuminuria OR albuminuria OR proteinuria OR 'urinary albumin creatinine ratio' OR 'urinary albumin excretion'). We included studies recruiting patients diagnosed by spirometry and providing data of microalbuminuria prevalence. We excluded studies in patients with other respiratory diseases associated with COPD, and studies published in predatory journals. The pooled prevalence of microalbuminuria was calculated using the DerSimonian-Laird binary random effects method, and the association of microalbuminuria with COPD and its severity was assessed using the Mantel-Haenszel random effects method. Results Twenty-five articles were included. The prevalence of microalbuminuria in patients with COPD was 49.3% [95% confidence interval (CI) 34.3-64.4%], which was higher than in the control population, with an estimated odds ratio of 3.94 (95% CI 2.25-6.60). In patients with severe to very severe COPD, it was higher than in those with mild to moderate COPD, with an estimated odds ratio of 4.55 (95%IC 2.85-7.28). Patients with COPD and microalbuminuria had an estimated decrease in PaO2 of 9.98 mmHg (95% CI 13.94-6.02) and an increase in PaCO2 of 8.08 mmHg (95% CI: 4.87-11.29). Interpretations and conclusions Microalbuminuria is highly prevalent in patients with COPD, with a much higher frequency than in the general population. It is more common in patients with more severe airflow obstruction and is associated with hypoxia and hypercapnia.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 4","pages":"584-592"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136335","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":"Authors' Response.","authors":"Agraj Abhishek, Manjeet Singh Chalga, Reetika Malik Yadav, Kshitij Agarwal, Vikram Vohra, Atul Tayade, Amber Kumar, Mandira Varma-Basil, Parul Mrigpuri, Hirva Manek, Padma Vikram Badhe, Sarika Gupta, Shuchi Bhatt, Anjan Das, Dhruvendra Pandey, C Ponnuraja, Sanghamitra Pati, Jyotirmayee Turuk, Pratibha Narang, Amita Athavale, Ira Shah, S S Mohanty, Arun George, Rashmi Rodrigues, Sushant Satish Mane, Anant Mohan, C R Chaudhary, Manoranjan Pattnaik, Radha Munje, Bhavna Dhingra, Anurag Singh, Rajesh Kumar Meena, Kirti Chaturvedy, Dhruva Chaudhary, Pavan Kumar Singh, Jeetendra Kumar Patra, Abhishek Sharma, Manika Sharma, Manjula Singh","doi":"10.25259/IJMR_2749_2026","DOIUrl":"10.25259/IJMR_2749_2026","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 2","pages":"332-334"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678519","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":"Zika virus positivity in Aedes aegypti mosquitoes and its genomic landscape from Pune, Western India.","authors":"Sreelakshmi P R, Mehrunnisa Raje, Surendra Kumar, Tanwee Das, Irrusappan Hari, Mahendra Jagtap, Ashwini Ramdasi, Supriya Hundekar, Sarah Cherian, Atul M Walimbe, Sachin Dhaigude, Prafulla Sonawane, Vinayak Ingale, Gajanan N Sapkal, Kavita Lole","doi":"10.25259/IJMR_3357_2025","DOIUrl":"10.25259/IJMR_3357_2025","url":null,"abstract":"<p><p>Background and objectives Zika virus cases were confirmed from Pune, Western India, during an outbreak in June 2024. We conducted an entomological investigation in the Pune municipal corporation area and aimed to characterise the Zika virus from Aedes aegypti mosquitoes at the genomic level. Methods An entomological survey was conducted covering 16 locations in the Pune Municipal Corporation, between June and August 2024. Adult mosquitoes were collected using aspirators, while larvae were collected with the standard dipping and pipetting method. Aedes vector density was assessed, and samples were pooled. Zika virus positivity was assessed using real-time RT-qPCR. Genomic characterisation of the strains was achieved by whole-genome sequencing using the Oxford Nanopore technology platform. Results A high density of Aedes mosquitoes was revealed in the Pune area. Zika virus positivity was observed in 34/128 (26.5%) of Aedes aegypti mosquito pools. Full genome sequences of two ZIKV isolates were recovered from adult mosquito pools. Their time-scaled phylogenetic analysis showed grouping within the Asian lineage, having a recent ancestral time of evolution around 2014, indicating the introduction of newer virus strains in the recent past in India. Mutations E-V473M and motif E-VNDT, indicative of faster viral replication and higher mosquito infectivity, were noted in only one of the two isolates. Interpretation and conclusions With a high positivity of the Zika virus in Aedes aegypti, this study highlights the ongoing risk prevailing in the Pune municipal corporation area. Distinct characteristics of the circulating strains of the virus, and their evolutionary links to different global strains, underlines the importance of continuous genomic surveillance in vectors and hosts.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 2","pages":"287-294"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678574","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":"Barriers to abstinence in alcohol related liver disease.","authors":"Mohit Varshney, Akansha Bhardwaj, Gandhrav Dua, Jithin Thomas Parel, Shasthry S M, Shiv Kumar Sarin","doi":"10.25259/IJMR_501_2026","DOIUrl":"10.25259/IJMR_501_2026","url":null,"abstract":"<p><p>Background and objectives Alcohol-related liver disease is a major public health concern, and continued alcohol use despite medical advice remains common. This study examined factors associated with ongoing alcohol use among patients with alcohol-related liver disease attending a tertiary care centre in north India. Methods A comparative cross-sectional study was conducted among 3759 adult male patients (mean age 43.8 ± 19.4 y) with alcohol-related liver disease. Patients were categorised as those with recent alcohol use (within the past 60 d) and those abstinent for more than 60 d. Data on alcohol use patterns, dependence severity, motivation to change, and perception of alcohol-related harm were obtained using structured assessments like the severity of dependence scale, readiness to change questionnaire, and a structured questionnaire developed for clinical use. Results A majority of patients reported recent alcohol use. Most were long-term (n=2932, 78% >5 y) and frequently drinking alcohol (n=2905, 77.3%) drinking alcohol three or more times per week), and 57.4% (n=2158) had attempted quitting previously. Individuals with ongoing alcohol consumption had higher dependence severity compared to abstinent patients. Despite this, many current drinkers reported awareness of alcohol-related harms and the need for treatment. Motivation to reduce or stop alcohol use was reported in both groups. Interpretation and conclusions Continued alcohol use among patients with alcohol-related liver disease appears strongly associated with dependence severity rather than lack of awareness or motivation. These findings highlight the need for integrated hepatology- addiction care approaches addressing both behavioural and biological aspects of alcohol dependence.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 4","pages":"522-527"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136405","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":"Self-collected cervical samples for detection of high-risk human papillomavirus: A community outreach approach in a remote region.","authors":"Mingma Lhamu Sherpa, Pesona Grace Lucksom, Mingma Sherpa, Anup Pradhan, Chamma Gupta","doi":"10.25259/IJMR_147_2026","DOIUrl":"10.25259/IJMR_147_2026","url":null,"abstract":"<p><p>Background and objectives Self collection of cervical samples is evolving as a potential screening approach to overcome cultural, geographical and logistical barriers that contribute to poor screening uptake. We conducted a study to compare performance of self and physician-collected cervical samples for high-risk human papillomavirus (hr-HPV) detection through community outreach approach in the hilly terrains of Sikkim. Methods A prospective longitudinal study was conducted for 2 y, sampling 210 sexually active women aged 18-65 y attending Central Referral Hospital and 3 district hospitals in Sikkim. Paired self and physician collected cervical samples were taken from consenting women for HPV DNA and pap test. Women who had total hysterectomy, diagnosed with cancer or were pregnant were excluded. Colposcopy was done among those positive for HPV infection. Result Prevalence of HPV (HPV DNA ± pap) was 17% (36/210) in this study of which HPV 16 was the most common variant (n=4,15%). Physician collected samples had the highest HPV detection rate (n=26,12%). Sensitivity and specificity were highest with physician-collected samples (71.4%, and 76.9%, respectively). Concordance between physician and self-sampling was good (Kappa 0.7). Women lost to follow up for colposcopy was 36% (n=13). Interpretation and conclusions Performance of physician-sampling was better than self-sampling and pap in the detection of hr-HPV. Physician-sampling should be used for HPV DNA detection when feasible.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 4","pages":"559-565"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136427","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}