International Angiology最新文献

{"title":"Female sex and outcomes of symptomatic carotid stenosis revascularization.","authors":"Giulio Accarino, Gaetano Lanza, Umberto M Bracale, Jessica Lanza, Giulia Colonna, Maurizio Taurino, Pasqualino Sirignano","doi":"10.23736/S0392-9590.25.05428-8","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05428-8","url":null,"abstract":"<p><p>Since stroke continues to be a major worldwide cause of death and disability, its prevention and treatment have become increasingly significant to public health. Up to 20% of all strokes are caused by carotid artery disease (CAD). Carotid revascularization techniques such as carotid endarterectomy (CEA) and carotid artery stenting (CAS) are established procedures aimed at reducing stroke risk. Recent studies, while confirming their effectiveness, suggest that women may experience different and sometimes less favorable post-operative outcomes compared to men. These differences stem from factors including anatomy, physiology, hormones, and socioeconomics. Current clinical guidelines rarely include gender-specific recommendations, as women have historically been underrepresented in clinical trials. However, the limited literature on risk assessment for women with CAD highlights significant differences. In this narrative review, we explore the impact of sex-related differences in CAD, outcomes of revascularization, and patterns of diagnosis and referral. We also highlight the gaps hindering personalized medical approaches. We examine the influence of anatomical and physiological variations on procedural risks, analyze hormonal effects on vascular wall physiology, and address metabolic differences between genders. Additionally, we discuss specific perioperative considerations for women and review current guidelines, identifying controversial issues arising from the lack of gender-based evidence. A key objective of this review is to emphasize the importance of research into personalized therapeutic strategies, aiming to improve the understanding of gender-specific influences and ultimately enhance outcomes for women undergoing carotid revascularization.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010474","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":"Screening for asymptomatic carotid stenosis: routine or selective?","authors":"Bruce A Perler","doi":"10.23736/S0392-9590.25.05400-8","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05400-8","url":null,"abstract":"<p><p>The current review discusses the advantages and disadvantages of routine vs. selective screening for asymptomatic carotid artery stenosis. The cost-effectiveness of screening programs is discussed. Furthermore, the rationale of offering selective screening, as well as the current recommendations regarding screening for asymptomatic carotid stenosis are presented. A selective screening strategy would identify individuals at high cardiovascular disease (CVD) risk early and would allow the timely initiation of conservative lifestyle measures and best medical therapy to prevent both stroke and CVD morbidity and mortality.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future in the management of patients with asymptomatic carotid artery stenosis.","authors":"Kosmas I Paraskevas, Sherif A Sultan, Ali F Aburahma, Wesley S Moore, Matthew Blecha, Piotr Myrcha, Clark J Zeebregts, Ales Blinc, Alun H Davies, Mario D'Oria, Mauro Gargiulo, Pavel Poredos, Alexei Svetlikov, Bruce A Perler, Seemant Chaturvedi, Gemmi Sufali, Luca Saba, Jens Eldrup-Jorgensen, Sean P Lyden, Carlo Setacci, Vincenzo DI Lazzaro, Tilman Reiff, Agnieszka Sawicka, Christos D Liapis, Gaetano Lanza, Gaia Spinetti, Antonino Bruno, Andrew N Nicolaides, Ankur Thapar, Maarten Uyttenboogaart, Arkadiusz Jawien, Dimitri P Mikhailidis, Francesco Spinelli, Francesco Stilo, Piotr Musialek, Victor Gurevich, Mauro Silvestrini, Young M Erben, Peter A Schneider, Gregory Y Lip, Christopher J White, Alan Dardik, James F Meschia, Mahmoud B Malas, Peter Gloviczki, Marc L Schermerhorn, Armando Mansilha","doi":"10.23736/S0392-9590.25.05401-X","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05401-X","url":null,"abstract":"<p><strong>Introduction: </strong>The optimal management of patients with asymptomatic (AsxCS) and symptomatic carotid stenosis (SxCS) is still debatable. The present article will discuss emerging technological advances for the diagnosis and management of patients with AsxCS.</p><p><strong>Evidence acquisition: </strong>PubMed/MedLine was searched until December 31, 2024 for studies in English discussing emerging technological advances in the diagnosis and management of patients with AsxCS.</p><p><strong>Evidence synthesis: </strong>Several technological advances have recently been reported, among others, nanoplastics and microplastics, artificial intelligence and machine learning in predictive analytics for stroke prevention, digital twins for personalized monitoring, electronic tattoos for continuous non-invasive monitoring, stroke risk prediction through plaque morphology and late-phase contrast-enhanced ultrasound. A brief overview of each technological advance is presented and discussed.</p><p><strong>Conclusions: </strong>The technological advances discussed in the present article will aid the early diagnosis of AsxCS as well as the individualized optimal management of patients with AsxCS.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795251","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":"Screening for asymptomatic carotid stenosis: routine or selective?","authors":"Bruce A Perler","doi":"10.23736/S0392-9590.25.05372-6","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05372-6","url":null,"abstract":"<p><p>Stroke is one of the most serious health care conditions in the western world. In the USA nearly 800,000 strokes occur annually and in the EU more than 1.1 million strokes occur each year. It has been estimated that in the United States, 66,000 of 600,000 first-time strokes, and in the UK 16,500 of 150,000 new strokes annually, occur secondary to thromboembolism from extracranial carotid disease, and many of these strokes occur in individuals who were completely asymptomatic until that stroke occurred. A simple diagnostic test, Duplex ultrasound, can identify significant internal carotid stenoses in patients with asymptomatic disease. However, routine screening of individuals is controversial. Tis commentary will discuss the pros and cons of routine screening for asymptomatic carotid disease.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772265","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":"Smoking and lower extremity artery disease.","authors":"Pier L Antignani, Pavel Poredoš, Aleš Blinc, Matija Cevc, Agata Stanek, Arkadiusz Jawien, Armando Mansilha","doi":"10.23736/S0392-9590.25.05302-7","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05302-7","url":null,"abstract":"<p><p>Cigarette smoking is a major preventable risk factor for lower extremity arterial disease (LEAD) and is strongly associated with a higher risk of disease progression, worse post-procedural outcomes, and increased healthcare utilization. Smoking provokes the development of atherosclerotic through different mechanisms. Endothelial cell dysfunction, oxidative stress, inflammation, and arterial stiffness are among the key factors related to the development of atherogenesis due to smoking. Smoking cessation among patients with LEAD and the use of smoking cessation methods, including pharmacological treatment, are mandatory. Given that smoking cessation interventions remain underutilized. Therefore, in this narrative review we highlight the importance of incorporating smoking cessation treatments as part of the medical management of LEAD. Regulatory approaches to reduce tobacco use and support smoking cessation have the potential to reduce the burden of LEAD.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772266","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":"Acute limb ischemia after occluded femoro-popliteal stents: a comparative analysis between endovascular revascularization vs. open bypass (FOCUS Study).","authors":"Giulia Bertagna, Nicola Troisi, Mario D'Oria, Mauro Gargiulo, Michele Antonello, Giovanni Pratesi, Stefano Michelagnoli, Roberto Silingardi, Giacomo Isernia, Gian Franco Veraldi, Giovanni Tinelli, Rocco Giudice, Arnaldo Ippoliti, Pierluigi Cappiello, Massimiliano Martelli, Sandro Lepidi, Raffaella Berchiolli","doi":"10.23736/S0392-9590.25.05366-0","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05366-0","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to compare the early and medium-term outcomes of endovascular revascularization versus bypass for the treatment of occluded femoro-popliteal stents in patients with acute limb ischemia (ALI) (insights of the OUT-STEPP multicentric registry).</p><p><strong>Methods: </strong>Between January 2016 and December 2021, 317 patients in 14 centers underwent treatment for symptomatic femoro-popliteal In-Stent Occlusion (ISO). Sixty patients with ALI were included into the present study: 42 (70%) underwent endovascular revascularization (Group ENDO), and 18 (30%) underwent open bypass surgery (Group OPEN). Early (30 days) results were assessed and compared between the two groups. Estimated 5-year outcomes were evaluated and compared with the log-rank test.</p><p><strong>Results: </strong>At 30 days no differences were found in terms of Major Adverse Cardiovascular Events (MACEs), acute kidney injury, reintervention(s), major amputation, and all-cause mortality between the two groups. The need for blood transfusions was similar in both groups (Group OPEN 7, 38.9% vs. Group ENDO 13, 30.1%; P=0.14). The mean length of hospital stay was higher for patients in Group OPEN (11.3±6.5 vs. 4.4±1.9 days; P<0.001). The overall median duration of follow-up was 35 (IQR 13-55.75) months. At 5 years there were no differences between the two groups in terms of survival (69.8% Group OPEN vs. 64.6% Group ENDO; P=0.76, log-rank 0.09), overall patency (71.4% Group OPEN vs. 72.8% Group ENDO; P=0.56, log-rank 0.34), freedom from reintervention(s) (76% Group OPEN vs. 63.4% Group ENDO; P=0.32, log-rank 0.99), and amputation-free survival (88.1% Group OPEN vs. 83.4% Group ENDO; P=0.76, log-rank 0.09).</p><p><strong>Conclusions: </strong>Endovascular revascularization and bypass seem to provide effective flow restoration in patients with ALI due to femoro-popliteal ISO. Open surgery was associated with longer hospital stay. At 5 years, no significant differences were found between the two groups in terms of overall patency, need for reintervention(s), and amputation-free survival, even though further studies on a larger sample size and potentially prospective will be necessary to validate these preliminary findings.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657208","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":"Use of microcirculatory parameters to evaluate foam sclerotherapy treatment of superficial chronic venous disease, associated or not with venotonic drug: randomized, double-blind trial.","authors":"Juliana M Vieira, Carmen L Porto, Walkyria Y Hara, Beatriz F Oliveira, Eliete Bouskela","doi":"10.23736/S0392-9590.25.05223-X","DOIUrl":"https://doi.org/10.23736/S0392-9590.25.05223-X","url":null,"abstract":"<p><strong>Background: </strong>Chronic venous disease (CVD) is a pathology with unfavorable outcome when treated and/or followed up incorrectly. In addition to macroscopic venous changes, CVD also causes changes in microcirculation. Based on these hypotheses, a non-invasive test to quantify the evolution of microangiopathy may be useful to assess the effects and benefits of treatment.</p><p><strong>Methods: </strong>Fifty female patients with varicose veins classified by clinical class C2 or C3 of the CEAP classification were selected and allocated randomly in two groups: foam sclerotherapy (FS) + micronized purified flavonoid fraction (MPFF) or FS + placebo, double-blind. Microcirculation was evaluated using Sidestream Dark Field techniques. The revised VCSS score was performed pre and post FS.</p><p><strong>Results: </strong>It was found an improvement on VCSS and all microcirculation parameters, in both groups, except on the number of pathological capillaries. When comparing the results between groups, a greater reduction in the diameters of dermal papilla was observed in the MPFF group (P=0.053), which, despite not being statistically significant, had an effect size of 0.55 (-0.01-1.10). In addition, capillary bulk and capillary limb also had a higher decrease in the MPFF group.</p><p><strong>Conclusions: </strong>FS treatment of the trunk veins reduced distal venous hypertension, improving microcirculation in all patients, helping to control the venous disease. All patients got therapeutic success (total occlusion or partial occlusion with improvement in venous reflux or reduction in venous caliber).</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657304","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":"Transcarotid artery revascularization in symptomatic carotid stenosis: a systematic review.","authors":"Francisco Garcia, Filipa Jácome, Joel Sousa, Armando Mansilha","doi":"10.23736/S0392-9590.24.05275-1","DOIUrl":"https://doi.org/10.23736/S0392-9590.24.05275-1","url":null,"abstract":"<p><strong>Introduction: </strong>Carotid endarterectomy is currently the gold standard treatment option for significant symptomatic carotid stenosis. Carotid artery stenting can be an alternative in selected patients, although with inferior results when compared with its open counterpart. Transcarotid artery revascularization (TCAR) emerged as a new option, with promising results. This study aims to systematically review current evidence of the safety of TCAR in patients with symptomatic carotid artery stenosis.</p><p><strong>Evidence acquisition: </strong>A systematic review of the literature was performed, according to PRISMA guidelines. Literature search was performed on the PubMed and Web of Science databases, which returned 178 studies. Eleven studies were selected. Data were extracted using predefined forms.</p><p><strong>Evidence synthesis: </strong>A total of 28326 symptomatic patients undergoing TCAR were included for analysis. Reported TIA/stroke rates after TCAR ranged between 2.3-3.3% in-hospital and 1.2-4.3% at 30-days. Similarly, in-hospital post-operative mortality was reported in 0.5-0.7% of the cases, and 1-4.9% at 30 days. After 1 year, TIA/Stroke and death rates ranged between 3.5-3.7% and 2.5-13%, respectively. Postoperative cardiovascular events were observed in up to 2.9% of the patients among the included studies. Cranial nerve injuries were reported in up to 0.7% of the cases, while surgical and vascular access complications ranged between 1.2-6.1%.</p><p><strong>Conclusions: </strong>TCAR has shown promising results for significant symptomatic carotid stenosis treatment, and may be a relevant alternative to carotid endarterectomy, especially in high-risk patients. Further studies are required to assess the effectiveness of TCAR and its comparability with carotid endarterectomy.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566568","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":"Pregnancy as a possible reason for recurrent varicosity after laser crossectomy.","authors":"Imre Bihari, Anna Bihari, Sara Lovasz, James Doherty, Péter Bihari","doi":"10.23736/S0392-9590.25.05295-2","DOIUrl":"10.23736/S0392-9590.25.05295-2","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy is one of the most important factors which promote the development and recurrence of varicose veins.</p><p><strong>Methods: </strong>Altogether 38 limbs of 33 women were evaluated who underwent laser crossectomy following childbirth and after that received US follow-up. Surgery was performed between October 2008 and October 2019. Timespan between surgery and pregnancy was 22.7±20.49 months. In 34 cases GSV, 2 SSV and in 2 cases GSV and perforator veins were treated. Diameter of treated veins was 6.26±3.25 mm. In most cases 1550 nm diode laser equipment and radial fiber was used (70%). Tip of the laser fiber was 1.0 later 0.5 cm to the femoral vein. Mean delivered energy was 100 J/cm along the saphenous veins and approximately double that near the SFJ.</p><p><strong>Results: </strong>Before gravidity there were flush closures of the SFJ with the femoral vein in 26 cases (EHIT1). In 12 cases there were stumps whose length was mean 7.5±3.73 mm. Between surgery and pregnancy none of them had any recurrency clinically nor with US. After delivery there were recurrent C2 varicosities in 18 cases (47.4%). Pathology of them were as follows: neo vascularization - 6; acc. ant. varicosity -5; perforator vein insufficiency -4 and recanalization -3 cases. This means that in 14/38 cases (36.8%) the SFJ became insufficient which contributed to recurrency. Few results are available about the impact of pregnancy on recurrency after varicose vein surgery.</p><p><strong>Conclusions: </strong>Our results suggest that recurrent varicosity results are acceptable using laser crossectomy. We couldn't judge if any of the used techniques could influence those very strong factors which cause recurrent varicosity during pregnancy.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"1-5"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440798","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":"How much volume of iodinated contrast medium leads to acute kidney injury in endovascular aortic repair?","authors":"Andrea Vacirca, Gianluca Faggioli, Antonino DI Leo, Sara Fronterrè, Rodolfo Pini, Enrico Gallitto, Chiara Mascoli, Stefania Caputo, Mauro Gargiulo","doi":"10.23736/S0392-9590.25.05286-1","DOIUrl":"10.23736/S0392-9590.25.05286-1","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a significant complication of endovascular aortic repair (EVAR), often related to iodinated contrast medium (ICM) exposure. This study aimed to analyze AKI incidence after EVAR in a monocentric case series and define a cutoff value for contrast volume (VIC) predictive of AKI.</p><p><strong>Methods: </strong>All elective EVARs performed on patients with abdominal aortic aneurysms (AAA) from 2012-2020 were analyzed for AKI incidence. AKI was defined by serum creatinine criteria (≥0.3 mg/dL within 48 hours, ≥1.5x baseline within a week) or urine output criteria (≤0.5 mL/kg/hour for 6 hours). Statistical analysis included Chi-square, Student's t-test, log-rank, ROC curve, and multivariate regression.</p><p><strong>Results: </strong>Among 732 patients undergoing EVAR, 27 (3.6%) developed AKI, with 21 (77.8%) cases identified as Contrast-Induced AKI (CI-AKI). AKI patients received significantly higher ICM (AKI 153±100 vs. 89±57 mL No-AKI, P=0.015). Independent predictors of AKI included preoperative CKD stage (OR1.72, 95% CI: 1.00-2.96, P=0.046) and intraoperative VIC ≥90 mL (OR=2.77, 95% CI: 1.11-6.89, P=0.025). AKI was associated with higher postoperative mortality (AKI 7.4% vs. 0.4% No-AKI, P=0.013) and prolonged hospitalization (AKI 7±6 vs. 5±5 days No-AKI, P=0.017). Survival at 24±21 months was significantly reduced in the AKI group (80±8% vs. 89±2%, P=0.026). A VIC-to-preoperative-eGFR ratio (VIC/pre-eGFR) ≥2.91 was predictive of CI-AKI (42.9% sensitivity, 93.7% specificity).</p><p><strong>Conclusions: </strong>While infrequent, AKI after elective EVAR significantly impacts short- and long-term outcomes. Preoperative CKD stage and intraoperative VIC are key predictors. Procedures should aim for a VIC/pre-eGFR ratio <2.91 to mitigate CI-AKI risk.</p>","PeriodicalId":13709,"journal":{"name":"International Angiology","volume":" ","pages":"24-33"},"PeriodicalIF":1.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440762","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}