Internal and Emergency Medicine最新文献

{"title":"Causes and predictors of recurrent unplanned hospital admissions in heart failure patients: a cohort study: a comment.","authors":"Yonathan Freund, Gad Cotter, Beth Davison, Oscar Mirò","doi":"10.1007/s11739-025-03891-w","DOIUrl":"https://doi.org/10.1007/s11739-025-03891-w","url":null,"abstract":"<p><p>We read with great interest the article authored by Kalter-Leibovici et al. Initial treatment in acute heart failure (AHF) is crucial in shaping short-term outcomes. Administered in the prehospital phase or emergency department (ED), early interventions-such as timing and dose of intravenous diuretics or vasodilators-may impact stabilization and decongestion. However, most predictive models, including the one discussed here, often omit these parameters, potentially missing an opportunity to refine risk stratification and anticipate complications.Beyond the ED, in-hospital treatment remains critical. The STRONG-HF trial demonstrated that intensifying medical therapy during hospitalization improves post-discharge outcomes, yet readmission rates remain high. This raises questions about the endpoint itself-whether it fully captures the benefits of optimized early care-or whether it reflects the inherent complexity of AHF as a progressive disease. Most ED-based studies focus on short- to mid-term readmissions (30-90 days), overlooking longer-term trajectories.Additionally, biomarkers such as NT-proBNP and renal function indicators, alongside advanced risk stratification tools, could enhance therapy guidance and discharge decisions. Yet, they remain underutilized in predictive models. Incorporating these parameters in future analyses may provide more actionable insights and improve long-term care strategies for AHF patients.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The comparison of endotracheal intubation and laryngeal tube insertion with face-to-face method in in-vehicle traffic accidents.","authors":"Merve Arslan, Ali Ekşi","doi":"10.1007/s11739-025-03885-8","DOIUrl":"https://doi.org/10.1007/s11739-025-03885-8","url":null,"abstract":"<p><p>Emergency airway management is a critical focus in prehospital emergency healthcare. The right technique and the right equipment may increase survival. The study aimed to compare endotracheal intubation and laryngeal tube insertion with the face-to-face method in difficult conditions such as in-vehicle traffic accidents in which the injured person is trapped inside the vehicle. The population of the study, which was carried out as experimental research, consisted of emergency health workers currently working in Bursa 112 Ambulance Services (n: 383). The study compared two different airway applications with face-to-face techniques using a simulator mannequin. Data were collected between February and May 2023 and the IBM Statistical Package for Social Sciences for Windows (SPSS 25) computer program was used for statistical data analysis. The suitability of the numerical variables for normal distribution was tested by the Shapiro-Wilk test. Since the variables did not conform to the normal distribution, they were given as median (Q1-Q3) values. Participants' preparation, implementation, and total times for ETI and LT were compared using the Wilcoxon test. The duration of face-to-face ETI and LT times were compared regarding participants' personal characteristics, experience status, and the training they received with the Mann-Whitney U test and the Kruskal-Wallis test. Categorical variables are given as number and percentage values. p < 0.05 was considered significant. In face-to-face endotracheal intubation, 24.3% of the participants were successful in the first attempt, 30% in the second attempt, 27.1% in the third attempt, 18.6% failed in all three attempts, and 38.6% performed esophageal intubation. 87.1% of the participants were successful in face-to-face laryngeal tube insertion in the first and 12.9% in the second attempt. The duration of face-to-face laryngeal tube placement was found to be significantly shorter than the duration of endotracheal intubation (p < 0.05). In face-to-face airway conduct, the length of endotracheal intubation time and the high risk of esophageal intubation make the laryngeal tube more advantageous than endotracheal intubation. Furthermore, the high number of attempts required for successful face-to-face endotracheal intubation may pose additional risks by causing destabilization in trauma patients requiring cervical stabilization.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower albumin levels are associated with 1-year mortality in older patients hospitalized for acute heart failure: THE ALBIMED-HF study.","authors":"Riccardo Barbiero, Martina Baccillieri, Davide Santagata, Marta Biancucci, Benedetta Pennella, Flavio Tangianu, Eleonora Nicolini, Andrea Maria Maresca, Francesco Dentali, Aldo Bonaventura","doi":"10.1007/s11739-025-03882-x","DOIUrl":"https://doi.org/10.1007/s11739-025-03882-x","url":null,"abstract":"<p><p>Hypoalbuminemia (i.e., albumin levels ≤ 3.5 g/dL) is a negative prognostic marker in several conditions, including acute heart failure (AHF). Hypoalbuminemia is common in patients hospitalized in Internal Medicine (IM) divisions. However, its role in predicting long-term mortality in AHF patients hospitalized in this setting is not clear. In THE ALBIMED-HF study, all patients hospitalized for AHF in the First Division of Internal Medicine at Ospedale di Circolo and Fondazione Macchi (ASST Sette Laghi, Varese, Italy) between January 1st and December 31st 2022 were retrospectively included. Clinical information was retrieved from patient electronic medical records. Four hundred and ninety-eight patients were considered for the present study (median age 85 [78-89] years). Median Charlson Comorbidity Index was 6 [5-7]. Heart failure (HF) with preserved ejection fraction was found in 40.6% of patients (N = 202/498). Median albumin levels were 3.2 [2.8-3.5] g/dL and hypoalbuminemia was recorded in 76.5% of patients (N = 381/498). At 12 months, 221 out of 498 patients (44.4%) died, and mortality was significantly higher in patients with hypoalbuminemia than in those without (N = 185/381 [48.6%] vs. N = 36/117 [30.8%], p < 0.001). Patients who died within 12 months were older, suffered more frequently from chronic kidney disease and active cancer, and exhibited higher C-reactive protein levels. At the multivariable analysis, hypoalbuminemia was independently associated with 12-month all-cause mortality (HR 2.41, 95% confidence interval 1.20-4.83). Hypoalbuminemia was independently associated with 12-month all-cause mortality in older patients with multiple comorbidities hospitalized for AHF in an IM division.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe burn injuries and the impact of mental health: insights from 7 years at Switzerland's leading burn center.","authors":"Michael-Alexander Pais, Mauro Vasella, Oliver Matthes, Elena Millesi, Alexander Kobler, Tabea Breckwoldt, Gregory Reid, Lukas Naef, Luzie Hofmann, Jennifer Ashley Watson, Philipp Karl Bühler, Pietro Giovanoli, Bong-Sung Kim","doi":"10.1007/s11739-025-03887-6","DOIUrl":"https://doi.org/10.1007/s11739-025-03887-6","url":null,"abstract":"<p><p>Severe burn injuries present significant global healthcare challenges, with outcomes significantly influenced by factors such as socioeconomic status, mental health conditions, and substance use, which vary across regions and healthcare systems. This study investigates the etiologies, treatment outcomes, and the impact of psychiatric conditions and controlled substance use on burn injuries in patients admitted to the intensive care unit at Switzerland's largest Burn Center. Data were retrospectively analyzed from 438 patients admitted to the University Hospital Zurich Burn Center ICU between 2016 and 2022. Variables assessed included baseline characteristics, burn etiologies, injury mechanisms, treatment modalities, complications, discharge outcomes, and mortality. Statistical analyses employed generalized linear models and logistic regression. Most burns occurred at home/leisure activities (43.4%), 21.2% at work. Pre-existing psychiatric conditions were present in 38.8% of patients, and 24.4% were under influence of controlled substances at the time of injury. These factors were associated with higher complication rates, increased surgeries, longer hospital stays, and lower survival rates. The overall in-hospital mortality rate was 15.8%, significantly linked to a history of controlled substance use. These findings highlight the significant impact of psychiatric conditions and use of controlled substances on burn injury outcomes, underscoring the importance of an interdisciplinary approach to treatment and management, particularly for patients with mental health and substance abuse histories.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytisine for smoking cessation in hospitalised smokers with cardiovascular diseases: an observational study.","authors":"Tedesco Erika, Ceccato Sofia, Torazzi Alessandro, Santin Laura, Losso Lorenzo, Bottardi Andrea, Casari Rebecca, Melchiori Silvia, Secchettin Erica, Ferrero Valeria, Arzenton Elena, Marini Paola, Lugoboni Fabio, Chiamulera Cristiano","doi":"10.1007/s11739-025-03888-5","DOIUrl":"https://doi.org/10.1007/s11739-025-03888-5","url":null,"abstract":"<p><p>Cigarette smoke is a significant risk factor for cardiovascular diseases (CVD). Among pharmacotherapy for smoking cessation, the plant alkaloid cytisine (CYT) -a nicotinic receptors partial agonist- has been shown to have a safe profile, with a minimal risk for drug interactions. Since previous studies have excluded CVD patients, there are few existing data examining CYT safety in this critical population. An observational prospective study was conducted in the Verona University Hospital (AOUI), Italy, to assess the safety and efficacy of CYT for smoking cessation. Thirty-six hospitalised participants from the Cardiology Department received oral CYT 1.5 mg for 25 days, according to the West Dosing Schedule (6 capsules for the first 3 days, gradually decreased up to 2 capsules on the last 6 days), in combination with supportive care. The primary endpoint was CYT safety, with 11 mild-moderate Adverse Drug Reactions (ADRs) reported by 9 (25%) participants. Initial insomnia (11%), nausea (6%), sleep disorders (6%), headache (3%), gastritis (3%), and diarrhoea (3%) were the most frequent symptoms. No serious or unexpected ADRs were identified, with no increase in cardiovascular events. Efficacy was assessed as self-reported 7-day point prevalence abstinence (PPA) at 3, 6 and 12 months post-quit. At the first follow-up, abstinence was also biochemically verified by exhaled carbon monoxide (CO) measurement, which was confirmed for 36% of participants. Considering lost to follow-up as relapsed patients, the PPA was 50%, 47% and 36% at 1st, 2nd and 3rd follow-up, respectively. These results may suggest that CYT has a well-established safety profile in hospitalised CVD patients, but further investigation is needed.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comanagement of surgical patients between neurosurgeons and internal-medicine clinicians: observational cohort study.","authors":"Ombretta Para, Joel Byju Valuparampil, Irene Merilli, Lorenzo Caruso, Asim Raza, Alberto Parenti, Carolina Angoli, Mohammed Al Refaie, Marzia Onesto, Lorenzo Barbacci, Carlo Nozzoli, Alessandro Della Puppa","doi":"10.1007/s11739-025-03866-x","DOIUrl":"https://doi.org/10.1007/s11739-025-03866-x","url":null,"abstract":"<p><p>The rising prevalence of chronic diseases have contributed to a population with high complexity of care. There has been an increasing need for a new organizational model based on the interaction in the same department between the specialist skills of surgical and medical disciplines. This study aims to describe the implementation of a hospitalist co-management program in a Neurosurgery Department (ND) and its impact on the incidence of medical complications, 30 days readmission rate for medical causes, number of transfers to Intensive Care Units (ICU)/Neurosurgical Intensive Care Unit (NICU) or to medical wards (MW), length-of stay (LOS), mortality and satisfaction of health workers. We conducted an observational study comparing changes before and after the Internal medicine-Neurosurgical Comanagement (INC) intervention. We conducted a retrospective evaluation of patients enrolled before the INC intervention and a prospective evaluation of those enrolled after the INC intervention was implemented. We defined the pre-INC intervention group as 380 patients admitted to the ND for neurosurgical disease between January 2022 and April 2022 and the post-INC intervention group as 367 patients admitted to the ND between January 2023 and April 2023. INC intervention was associated with a significant decrease in medical complications during the hospital stay (OR 0.52; 95% CI; 0.39-0.70, p < 0.001), 30 days in-hospital readmission for medical reasons (OR 0.95; 95% CI 0.93-0.97, p < 0.001) and numbers of transfers to ICU/NICU (OR 0.31; 95% CI; 0.17-0.55, p < 0.001) or MW (OR 0.51; 95% CI 0.33-0.77, p = 0.002). During the INC intervention period, we observed a high satisfaction rate in health workers, evaluated by standardized questionnaire. In our study, LOS, in-hospital mortality and 30-day mortality were not significantly associated with INC. Hospitalist co-management in Neurosurgical Departments was associated with a reduced incidence of medical complications, 30-days in-hospital readmission and numbers of transfers to ICU/NICU or MW with a high satisfaction rate among healthcare workers, but without a significant decrease in LOS and mortality rate.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linezolid-induced neuropathy in Nocardia pneumonia.","authors":"Yiwei Wang, Miao Dai","doi":"10.1007/s11739-025-03886-7","DOIUrl":"https://doi.org/10.1007/s11739-025-03886-7","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection and management of postoperative atrial fibrillation after coronary artery bypass grafting or non-cardiac surgery: a survey by the AF-SCREEN International Collaboration.","authors":"Giuseppe Boriani, Jacopo F Imberti, William F McIntyre, Davide A Mei, Jeff S Healey, Renate B Schnabel, Emma Svennberg, A John Camm, Ben Freedman","doi":"10.1007/s11739-025-03861-2","DOIUrl":"https://doi.org/10.1007/s11739-025-03861-2","url":null,"abstract":"<p><p>We developed a survey to describe current practice on the detection and management of new-onset postoperative atrial fibrillation (POAF) occurring after coronary artery bypass grafting (CABG) or non-cardiac surgery. We e-mailed an online anonymous questionnaire of 17 multiple choice or rank questions to an international network of healthcare professionals. Between June 2023 and June 2024, 158 participants from 25 countries completed the survey. For CABG patients, 62.7% of respondents reported use of telemetry to detect POAF on the ward until discharge, and 40% reported no dedicated methods for monitoring AF recurrences during follow-up. The largest number (46%) reported prescribing oral anticoagulants (OACs) at discharge if patients were at risk according to CHA₂DS₂-VASc/CHA₂DS₂-VA scores, and the most common duration of OAC therapy was 3 months to 1 year (43%). For non-cardiac surgery patients, POAF detection methods varied, with 29% using periodic 12-lead ECG and 27% using telemetry followed by periodic ECGs. For monitoring AF recurrence, 33% reported planned cardiology visits with ECG. Regarding OAC prescription during follow-up, 51% reported they prescribe OACs only for patients who are at risk of stroke, and 42% prescribe OACs for an interval of 3 months to 1 year. The most commonly reported barrier to OAC prescription was the lack of randomized controlled trial data. For both CABG and non-cardiac surgery, the reported methods for POAF detection and recurrences monitoring were heterogeneous and prescription patterns for OACs varied greatly. The most frequently reported concern about long-term anticoagulation was lack of randomized data, indicating the urgent need for sound studies that inform daily clinical practice.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fertility in male patients with familial Mediterranean fever and paternal effect of FMF on pregnancy outcomes and complications.","authors":"Kerem Parlar, Feyza Nur Azman, Sena Ladin Sıcakyüz, Melike Rızaoğlu, Enes Azman, Mebrure Burçak Yüzbaşıoğlu, Dilvin Korkmaz, Serdal Uğurlu","doi":"10.1007/s11739-025-03881-y","DOIUrl":"https://doi.org/10.1007/s11739-025-03881-y","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigates the impact of Familial Mediterranean Fever (FMF) and its treatment on male infertility, and the paternal effect of FMF on pregnancy outcomes or complications.</p><p><strong>Methods: </strong>We enrolled 282 adult male FMF patients and excluded 102 for never attempting pregnancy. Demographic and clinical data, including MEFV mutation status and treatment history, were collected. Fertility status and pregnancy outcomes were assessed through interviews and medical records. Statistical analysis was performed using Fisher's exact test, with significance set at p < 0.05.</p><p><strong>Results: </strong>Among the 180 patients who attempted pregnancy, 177 (98.3%) achieved pregnancy. Only 3 (1.7%) were infertile. A total of 452 pregnancies were conceived, with 85.0% resulting in live births. Miscarriages occurred in 11.9%, stillbirths in 0.9%, and ectopic pregnancies in 0.9%. The most common complication was preterm birth (4.2%), followed by gestational diabetes (2.1%). Eleven patients with amyloidosis achieved 39 pregnancies, with no cases of infertility.</p><p><strong>Conclusion: </strong>FMF does not lead to decreased male fertility or adverse pregnancy outcomes. Colchicine is safe for use during conception. Male FMF patients and their partners do not need additional precautions during pregnancy attempts and follow-up.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors for successful weaning from mechanical ventilation in the internal medicine department.","authors":"Gal Cohen, Idan Bergman, Alaa Atamna, Avishay Elis","doi":"10.1007/s11739-025-03860-3","DOIUrl":"https://doi.org/10.1007/s11739-025-03860-3","url":null,"abstract":"<p><p>The aging of the Israeli population along with a shortage of ICU beds have led to hospitalization of invasive mechanical ventilation patients in internal medicine departments, where, as opposed to ICU, the treatment is less than optimal. The aims of the study were to evaluate the predictive factors for successful weaning from mechanical ventilation in ventilated patients admitted to internal medicine departments. A retrospective study that included non-COVID 19 ventilated patients in internal medicine departments in a university affiliated hospital in Israel between the years 2018-2019. We compared datapoints between patients who were weaned from ventilators versus those who remained ventilated during the hospitalization, and defined demographic and clinical predictive factors for successful weaning. Data were collected from electronic medical records and included demographic, clinical, laboratory and ventilator information. The study group included 348 patients. The rate of successful weaning was 19%; patients who were successfully weaned were primarily functionally independent prior to ventilation, ventilated with low PEEP values, had high hemoglobin and albumin levels alongside with low CRP and lactate levels. Those who remained ventilated either required vasopressor treatment, had positive blood cultures or had lower GFR levels. The overall in-hospital mortality rate was 60%, while the 30-day mortality rate was lower in the extubated group [214 (76%) vs. 6 (9%), P < 0.0001]. Our findings highlight the low rate of weaning from ventilation in the department of medicine, with higher mortality rate among the remained ventilated patients. Various favorable clinical parameters might predict successful weaning.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}