International heart journal最新文献

{"title":"Investigation of Factors for a Poor Prognosis in Rutherford 4 Patients Who Undergo Endovascular Treatment.","authors":"Tetsuo Yamanaka, Michiaki Higashitani, Akihiro Matsui, Kentaro Jujo, Naotaka Murata, Takahide Kodama, Atsushi Mizuno, Yoshimaro Ichinohe, Toru Fukatsu, Daisuke Ueshima","doi":"10.1536/ihj.24-412","DOIUrl":"10.1536/ihj.24-412","url":null,"abstract":"<p><p>Current classifications of chronic limb-threatening ischemia (CLTI) are insufficient to identify Rutherford (R) 4 patients with a poor prognosis. This study aimed to investigate the prognostic factors for patients with R4 CLTI who undergo endovascular treatment (EVT) using data from the Tokyo-taMA peripheral vascular intervention research COmraDE (TOMA-CODE) registry and to propose a risk-scoring system. We analyzed the data of 2,248 prospectively enrolled patients from the registry, divided into 3 groups: intermittent claudication (IC), n = 1,185; R4, n = 401; and R5-6, n = 662. We ascertained amputation-free survival (AFS) 1, 6, 12, 18, and 24 months post-EVT. The 2-year major AFS rates for IC, R4, and R5-6 were 0.944 (95% confidence interval [CI]: 0.921-0.960), 0.830 (0.753-0.885), and 0.576 (0.508-0.638), respectively. The final logistic regression model after addressing optimism included 5 factors: Non-ambulatory status, White blood cell count ≥ 10,000/μL, Revascularization for lesions in the infrapopliteal arteries, previous history of Cerebrovascular disease, and New York Heart Association class III-IV Heart failure (NoWRiCH score). We developed 3 risk-scoring models. When non-ambulatory status was assigned 2 points and the other factors were assigned 1 point each, the prognosis of R4 patients with ≥ 2 points was equivalent to that of R5-6 patients (R4/R5-6; 2-year survival rate, 95% CI: 0.423, 0.204-0.628, P < 0.001/0.576, 0.508-0.638, P < 0.001). The NoWRiCH score facilitates the identification of R4 patients with a poor prognosis.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":" ","pages":"88-95"},"PeriodicalIF":1.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004716","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":"Percutaneous Transvenous Mitral Commissurotomy for Patients with Rheumatic Heart Disease.","authors":"Xin Li, Yinfan Zhu, Jiajun Liang, Wenjian Jiang, Yuyong Liu, Hongjia Zhang","doi":"10.1536/ihj.24-330","DOIUrl":"10.1536/ihj.24-330","url":null,"abstract":"<p><p>Rheumatic heart disease remains common in developing countries. Current guidelines recommend percutaneous mitral commissurotomy (PTMC) as the preferred treatment for patients with rheumatic mitral stenosis (MS). This study reports the clinical outcomes of PTMC for rheumatic MS in contemporary Chinese patients and analyzes prognostic factors.Data from patients who underwent PTMC at our center between January 2007 and July 2023 were retrospectively analyzed. The primary outcome was the composite of all-cause death, repeated PTMC, and mitral valve surgery. Survival curve was constructed using the Kaplan-Meier method. Multivariate Cox regression analysis was used to identify prognostic predictors, and hazards ratio (HRs) with 95% confidence intervals (CIs) were reported.A total of 262 patients with a mean age of 50.1 ± 14.1 years were included. The median follow-up time was 69.5 months. Kaplan-Meier analysis showed that primary outcome-free survival rate was 85.6% ± 2.5%, 67.2% ± 4.2%, and 55.2% ± 6.5% at 5, 10, and 15 years, respectively. In multivariate Cox regression analysis, preprocedural transmitral E peak velocity (Emax) (HR = 1.009, 95% CI: 1.002-1.016, P = 0.015), postprocedural mitral valve orifice area (MVOA) (HR = 0.284, 95% CI: 0.108-0.746, P = 0.011), and postprocedural mitral regurgitation (MR) ≥ 2+ (HR = 2.710, 95% CI: 1.382-5.314, P = 0.004) were identified as the independent predictors of the primary outcome.The clinical outcomes of PTMC are favorable for suitable patients with rheumatic MS. Meanwhile, preprocedural Emax, postprocedural MVOA, and postprocedural MR ≥ 2+ are the prognostic factors.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":" ","pages":"60-65"},"PeriodicalIF":1.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004722","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":"Ticagrelor and the Risk of In-Hospital Gout.","authors":"Hong Liu, Guo Jiangxue, Yu Dong, Ying Yang, Xitong Yang, Biao Sun, Lilan Ma, Tao Li, Xin-Hua Wu","doi":"10.1536/ihj.24-306","DOIUrl":"10.1536/ihj.24-306","url":null,"abstract":"<p><p>Ticagrelor, an effective antiplatelet for acute coronary syndrome (ACS), may elevate serum uric acid (SUA), potentially causing gout. This study aims to identify risk factors for ticagrelor-induced in-hospital gout in patients with ACS and create a predictive model for clinical use.A total of 1164 patients with ACS treated with ticagrelor (n = 640) or clopidogrel (n = 524) were retrospectively analyzed. The incidence of in-hospital gout and changes in SUA levels were compared between the groups. Patients with ticagrelor were further divided into gout and non-gout groups to identify risk factors using logistic regression. A nomogram model was constructed based on significant risk factors.The incidence of in-hospital gout was significantly higher in patients with ticagrelor than in patients with clopidogrel (9.8% versus 1.9%, P < 0.001). There were significant differences in SUA levels between the groups. Logistic regression revealed alcohol consumption, total cholesterol, and baseline SUA as independent risk factors for gout. A nomogram model was developed and demonstrated good predictive accuracy.Ticagrelor was associated with a higher risk of in-hospital gout than clopidogrel in patients with ACS. Alcohol use, total cholesterol, and baseline uric acid are key risk factors. The nomogram model developed in this study can assist in predicting the risk of in-hospital gout in patients with ACS treated with ticagrelor.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":" ","pages":"21-27"},"PeriodicalIF":1.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004729","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 Respiratory Sinus Arrhythmia Increase Nocturnal Blood Pressure?","authors":"Miho Kuramoto, Masami Aizawa, Yuki Kuramoto, Masaaki Okabe, Yasushi Sakata, Yoshifusa Aizawa","doi":"10.1536/ihj.24-247","DOIUrl":"10.1536/ihj.24-247","url":null,"abstract":"<p><p>By ambulatory blood pressure monitoring (ABPM), nocturnal blood pressure (BP) may increase before heart rate (HR), but the details are unknown.Among 102 participants who underwent ABPM, > 90% on hypertension treatment, the averaged BP (HR) data were examined for the time at which the BP (HR) increased significantly above the mean midnight BP (HR) between 3:00 AM - 9:00 AM in all patients and in subgroups divided by clinical variables. Participants were also divided according to the respiratory sinus arrhythmia (RSA) index, which is the ratio of the longest and shortest RR intervals obtained under normal breathing, and the effects of RSA on the nocturnal hemodynamics were examined.The average age of the patients was 70 ± 11 years, and there were 47 (46.1%) males. After midnight, the BP increased and was significantly greater than the midnight BP at 5:00 AM. The time of significant increase in BP was affected by clinical variables and the RSA index; an RSA index < 5% (> 10%) was associated with the earliest (latest) time of BP increase. However, the HR remained unchanged until 7:00 AM or later. According to the ABPM data, a discordant time course between BP and HR and the effect of RSA were evident during the nocturnal period.BP increased earlier than HR toward dawn, and this phenomenon was affected by clinical variables. A low RSA index facilitated the onset of BP increase. The underlying mechanisms and clinical significance of the role of RSA in circulatory regulation remain to be investigated.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":" ","pages":"81-87"},"PeriodicalIF":1.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004706","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":"Age-Specific Changes in Physical Function in Patients with Acute Decompensated Heart Failure.","authors":"Yuta Nakaya, Masanori Akamatsu, Kaho Yakushiji, Akiyoshi Ogimoto, Hiroaki Kitaoka","doi":"10.1536/ihj.24-168","DOIUrl":"10.1536/ihj.24-168","url":null,"abstract":"<p><p>Cardiac rehabilitation (CR) improves physical function in patients with acute decompensated heart failure (ADHF) and frailty. However, few studies have assessed physical function through multiple measures during hospitalization; moreover, the effect of age remains unclear. This study aimed to evaluate age-specific changes in physical function during the acute-phase treatment period in patients with ADHF. Patients with ADHF hospitalized between June 2018 and June 2023, who were aged ≥ 60 years and underwent CR, were included in the study. Physical function assessments at admission and discharge included grip strength, quadriceps isometric strength, short physical performance battery (SPPB), gait speed, and frailty. Changes in physical function from admission to discharge were assessed. The mean age of the 531 patients was 79.8 ± 9.0 years and 58% were male. Physical function at admission and discharge significantly decreased with age according to all measures. In patients aged ≥ 90 years, quadriceps isometric strength (0.27 ± 0.11 kgf/BW kg) and the SPPB score (4.5 ± 3.6 points) were severely impaired at admission. However, no significant differences were observed in changes in physical function according to age; the improvement in the SPPB score tended to increase with age (+1.7 ± 1.9, +2.3 ± 2.1, +2.2 ± 2.4, and +2.3 ± 1.8, in the 60-69-, 70-79-, 80-89-, and ≥ 90-year age groups, respectively). The improvement in frailty was similar in all groups. Although physical function declined with age, the changes in physical function were similar in patients with ADHF at any age above 60 years who underwent CR.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":" ","pages":"66-73"},"PeriodicalIF":1.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004616","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":"Detection of Cholesterol Crystals Using the Filter Paper Rinse Method in Very Late Stent Thrombosis Cases.","authors":"Saki Mizobuchi, Keisuke Kojima, Yudai Tanaka, Yuta Hotsubo, Shohei Migita, Masatsugu Miyagawa, Katsunori Fukumoto, Yuki Nakajima, Yasunari Ebuchi, Riku Arai, Tomoyuki Morikawa, Takashi Mineki, Nobuhiro Murata, Daisuke Fukamachi, Yasuo Okumura","doi":"10.1536/ihj.24-450","DOIUrl":"https://doi.org/10.1536/ihj.24-450","url":null,"abstract":"<p><p>Very late stent thrombosis (VLST) is a rare but critical complication of stent placement. In this report, we present 2 VLST cases diagnosed with neoatherosclerosis by detecting cholesterol crystals (CCs) via the filter paper rinse method. In terms of differentiating between neoatherosclerosis and stent thrombosis. There was no visible thrombus observed on thrombus aspiration. Examination of the blood sample obtained from the thrombus aspiration using the filter paper rinse method showed the presence of CCs under polarized light microscopy, thus, diagnosing VLST caused by neoatherosclerosis. Diagnosis of neoatherosclerosis would provide a rationale for intensive lipid-lowering therapy.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 1","pages":"175-178"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079857","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":"Esaxerenone Attenuates Cardiac Hypertrophy in a Pressure Overload Model in Mice.","authors":"Ou Hayashi, Yasuhiro Izumiya, Hiroya Hayashi, Hirotoshi Ishikawa, Daiju Fukuda","doi":"10.1536/ihj.24-169","DOIUrl":"https://doi.org/10.1536/ihj.24-169","url":null,"abstract":"<p><p>Esaxerenone, a non-steroidal mineralocorticoid receptor (MR) blocker, exhibits high selectivity for MR. While clinically used as an anti-hypertensive drug, its impact on cardiac remodeling remains poorly understood. This study investigated the effect of esaxerenone on pressure overload-induced cardiac hypertrophy in mice.Eight-week-old C57BL/6 mice underwent either transverse aortic constriction (TAC) or sham surgery. Animals were divided into 2 groups: 0.003% (3.0 mg/kg) Esaxerenone-fed (EX) and normal-fed (CNT) groups (n = 64, Sham/CNT = 12, Sham/EX = 13, TAC/CNT = 18, TAC/EX = 21). Cardiac gene expressions were analyzed using quantitative real-time PCR.Food intake and body weight variations showed no significant differences between CNT and EX groups during the 2-week experimental period. The mortality rate from 24 hours after TAC surgery to the end of the experiment was 30.8% in the CNT group, however, all mice survived following TAC surgery in EX group. CNT group showed a remarkable increase in heart weight/tibial length ratio 2 weeks after TAC compared with the Sham group. The EX group demonstrated a significant decrease in HW/TL following TAC surgery (-23.4%, P = 0.041). Masson's trichrome staining revealed that the TAC/CNT group had a significantly higher proportion of fibrotic area than the Sham/CNT group. However, the TAC/EX group had a slightly lower proportion of fibrotic area than the TAC/CNT group. In cardiac gene expression analysis, ANP and Collagen 3a1 were upregulated in the TAC group but were significantly reduced following treatment with esaxerenone.Esaxerenone attenuates cardiac hypertrophy and hypertrophy-related gene expression, resulting in improved survival in a pressure overload model in mice.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 1","pages":"137-143"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079860","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":"Difference in Strategy and Clinical Outcomes of Left Main Disease in Japan and Non-Japanese Countries.","authors":"Takayuki Warisawa, Christopher M Cook, Yousif Ahmad, James P Howard, Henry Seligman, Christopher Rajkumar, Shunichi Doi, Sonoka Yuasa, Akihiro Nakajima, Takumi Toya, Masafumi Nakayama, Yuetsu Kikuta, Yoshiaki Kawase, Hidetaka Nishina, Rasha Al-Lamee, Amir Lerman, Hitoshi Matsuo, Yoshihiro J Akashi, Javier Escaned, Justin E Davies","doi":"10.1536/ihj.24-375","DOIUrl":"https://doi.org/10.1536/ihj.24-375","url":null,"abstract":"<p><p>Although state-of-the-art therapy for left main disease (LMD) has been demonstrated to improve overall cardiovascular outcomes, it remains unclear whether differences in strategy and outcomes for Japanese and non-Japanese patients can be observed in a contemporary treatment.In this international multicenter registry, we analyzed 314 patients who received state-of-the-art management for LMD, including physiology-guided revascularization, coronary interventions using the latest drug-eluting stents aided by intracoronary imaging, or surgical procedures employing internal thoracic artery grafts, in conjunction with guideline-directed medical therapy. The patient cohort was divided into Japanese (n = 122) and non-Japanese (n = 192) groups. The primary endpoint was major adverse cardiovascular events (MACE), defined as death, non-fatal myocardial infarction, and ischemia-driven target lesion revascularization. Propensity score matching was utilized to account for baseline clinical variables.Baseline and lesion characteristics differed among groups, demonstrating higher frequency of diabetes and chronic kidney disease, higher SYNTAX score, and more severe stenosis in the Japanese cohort, resulting in a higher rate of revascularization performed (P < 0.05 for all). Percutaneous coronary intervention was significantly more frequently selected as the revascularization option (P < 0.001). While there were no significant differences in MACE between the 2 groups before adjustment, following adjustment, the Japanese cohort demonstrated significantly lower MACE at 4 years (6.3% versus 16.7%; HR: 0.37; 95%CI: 0.14-0.97; P = 0.042). Multivariate analysis further confirmed an independent association between Japanese patients and a reduced 4-year MACE risk (HR: 0.37; 95%CI: 0.14-0.96; P = 0.040).In a contemporary study with state-of-the-art therapy for LMD, patients who underwent treatment in Japan demonstrated better cardiovascular outcomes.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 2","pages":"202-212"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751907","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":"Ventricular Tachycardia Ablation Using Map Merge Capable of Integrating Multiple Sessions.","authors":"Jun Yokota, Katsuhito Fujiu, Kent Doi, Norihiko Takeda","doi":"10.1536/ihj.24-685","DOIUrl":"https://doi.org/10.1536/ihj.24-685","url":null,"abstract":"<p><p>This case report presents a novel approach for ventricular tachycardia (VT) ablation in a patient with cardiac sarcoidosis, utilizing the Map Merge function of the CARTO 3 system to integrate mapping data from multiple ablation sessions. A 62-year-old male with recurrent VT underwent initial endocardial ablation, where voltage mapping revealed no low-voltage areas (LVA) in the endocardium, though pace mapping matched clinical VT morphology. Fragmentation potentials were noted in the coronary vein, indicating a probable epicardial substrate. Ablation successfully suppressed VT, but recurrence occurred within 4 days, prompting a second, epicardial approach. During this session, voltage mapping identified broad LVAs with late potentials in the epicardium, aligning with prior endocardial sites. The Map Merge function enabled superimposing maps from both sessions, confirming spatial consistency between endocardial and epicardial LVAs and enhancing the precision of ablation targeting. Post-ablation, no VT recurrence was observed.This case underscores the clinical value of Map Merge, which improves procedural accuracy by integrating data across temporally distinct sessions, especially in VT cases involving epicardial substrates. By enabling comprehensive mapping without repeated epicardial mapping, Map Merge facilitates efficient identification and alignment of LVAs and abnormal potentials. This approach may improve outcomes in VT ablation by ensuring precise targeting, particularly in cases requiring endo-epicardial intervention.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 2","pages":"327-328"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752566","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":"Upstream Stimulatory Factor 2 Protects Cardiomyocytes by Regulating Mitochondrial Homeostasis.","authors":"Wenbin Wu, Kexin Zhao, Kejuan Li, Ziwei Zhu, Yongnan Li, Jianshu Chen, Hong Ding, Xiaowei Zhang","doi":"10.1536/ihj.23-619","DOIUrl":"https://doi.org/10.1536/ihj.23-619","url":null,"abstract":"<p><p>Myocardial ischemia and hypoxia are the main causes of heart failure, and cardiomyocyte apoptosis induced by mitochondrial injury is the basis of adverse heart remodeling and heart failure. Upstream stimulatory factor 2 (USF2), a transcription factor involved in multiple cellular processes, was recently shown to play an active role in mitochondrial function and energy homeostasis. However, its involvement in cardiovascular disease has not been previously reported. In this study, we demonstrated that under hypoxic conditions, USF2 protein expression can be degraded via the ubiquitin-proteasome pathway in cardiomyocytes. The deletion of USF2 results in mitochondrial dysfunction and exacerbates mitochondrial damage, ultimately promoting apoptosis. Mechanistically, we demonstrated that USF2 deficiency induces apoptosis in cells by modulating the AMPK/mTOR signaling pathway. In conclusion, this study provides new insights into the protective role of USF2 in hypoxic cardiomyocyte injury and indicates that USF2 could be a potential therapeutic target for myocardial hypoxia.</p>","PeriodicalId":13711,"journal":{"name":"International heart journal","volume":"66 2","pages":"302-312"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752560","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}