International Urogynecology Journal最新文献

{"title":"The Urinary, Vaginal, and Perineal Microbiome: Commonalities and Differences.","authors":"Anisa Nasse, Melline Fontes Noronha, Linda Brubaker, Alan J Wolfe","doi":"10.1007/s00192-025-06144-8","DOIUrl":"https://doi.org/10.1007/s00192-025-06144-8","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The relationship of adjacent pelvic microbiomes in women has not been well characterized. This study aimed to compare the microbiomes of catheterized urine, vagina, and perineum from well-characterized women undergoing urogynecologic surgery.</p><p><strong>Methods: </strong>Clinical data was extracted from the electronic medical record. Participants contributed three samples (catheterized urine, vaginal swab, perineal swab) that were subjected to DNA sequencing following amplification of hyper-variable region 4 (V4) of the bacterial 16S rRNA gene. The sequences were processed, annotated, and decontaminated. Only participants with sequence-positive samples from all three samples were included in the analytic cohort. Alpha (within-sample) and beta (between-sample) diversity indices were computed, and the microbiome compositions within each participant and across all participants were compared.</p><p><strong>Results: </strong>The mean age of the 104 participants was 60.5 years old (range 35-89) with a mean BMI of 28.2 kg/m²; most (89%) were White. Lactobacillus was the most common genus detected, with a mean relative abundance of 64.8% in the bladder, 67.4% in the vagina, and 42.6% in the perineum. Across these niches, alpha diversity differed significantly, whereas beta diversity was similar. Within an individual, the three microbiomes were very similar to each other, with the bladder and vagina considerably more similar to each other than to the perineum. Taxonomic diversity tended to increase with age and was highest in overweight participants.</p><p><strong>Conclusion: </strong>The microbiomes of the bladder, vagina, and perineum of women are very similar to each other.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979067","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":"Perceptions and Needs of Postpartum Women with Urinary Incontinence on Self-Management and Application of a Digital Human: A Qualitative Study.","authors":"Zhentong Zhong, Shuxian Li, Yingjie Hu, Ao Huang, Wenzhi Cai","doi":"10.1007/s00192-025-06131-z","DOIUrl":"https://doi.org/10.1007/s00192-025-06131-z","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Postpartum women with urinary incontinence (UI) frequently struggle to control their UI. By practicing self-management, patients can effectively manage their UI. A digital human could be used to support self-management. In addition to understanding the perception by postpartum women with UI of UI threats, self-management, and application of the digital human, this study attempts to collect related functional needs of the digital human.</p><p><strong>Methods: </strong>Semi-structured interviews were used to recruit 16 postpartum urine leakage-afflicted women who attended a tertiary hospital in Shenzhen, China, in July 2024, to this study. The interview transcripts, based on the traditional content analysis, were summarized and analyzed using the Technology Acceptance Model and the Health Belief Model.</p><p><strong>Results: </strong>One self-management behavior that postpartum women with UI often reported was seeking health care. Regarding perceived UI threats, these women typically engage in self-management at the social contact level. Patients noted a variety of barriers to self-management. Patients' attitudes toward the digital human assisting with UI self-management were positive and skeptical. Patients characterized their functional needs as a digital human in two areas: access to health care and home self-management. When asked about their intention to use the digital human, patients showed both willingness to try and a lack of interest.</p><p><strong>Conclusions: </strong>Postpartum women face various challenges with UI self-management, and health care organizations should provide specific support. The digital human can provide necessary assistance. To increase the digital human's applicability, the researchers will gather more patient perceptions and needs in a subsequent step, spanning a wider range of backgrounds.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996886","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":"Shared Decision-Making (SDM) for Female SUI: Current Practice in Three Western Countries.","authors":"Nienke J E Osse, Karine Gontijo-Santos Lima, Marian K Engberts, Hugo W F van Eijndhoven, Wenche M Klerkx, Michiel R de Boer, Philippe D Violette, Laura N Nguyen, Rufus Cartwright, Marco H Blanker, Paul L P Brand","doi":"10.1007/s00192-025-06147-5","DOIUrl":"https://doi.org/10.1007/s00192-025-06147-5","url":null,"abstract":"<p><strong>Introduction: </strong>Different decision-making styles can be used to provide counselling for the multiple reasonable treatment options for patients with stress urinary incontinence (SUI). Shared decision-making (SDM) is currently advocated as the preferred style for preference sensitive decisions, as SDM takes patient preferences into account. This study aimed to map the current decision-making process for SUI in three Western countries.</p><p><strong>Methods: </strong>We included 124 patients and 18 physicians in a multicentre, prospective study in five hospitals in Canada, the United Kingdom and the Netherlands. We used patient and physician versions of the Control Preference Scale (CPS) questionnaires and examined audio-recordings of consultations with the OPTION-5 instrument to assess the degree of SDM.</p><p><strong>Results: </strong>Most patients (63%) perceived the decision-making as informative, some (29%) as shared and only a few (8%) as paternalistic. Dutch patients more often perceived the decision-making as informative than UK or Canadian patients. Patients' preferred and perceived decision-making styles matched in 70% of consultations. Patients' and physicians' perceptions of decision-making were the same in 60% of consultations, but their perceptions of SDM use did not match. This also did not match the OPTION-5 scores reflecting the use of SDM. Almost all patients were satisfied with the decision-making they perceived.</p><p><strong>Conclusion: </strong>Most patients and physicians prefer and perceive the current decision-making process as informative decision-making. However, patients and physicians have different perceptions of their mutual consultation. This highlights the imprecise concept of SDM for both patients and physicians.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009291","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":"Factors Affecting Follow-up for Specialty Postpartum Care after Obstetric Anal Sphincter Injury at a Single U.S. Institution.","authors":"Simone Reaves, Pamela J Levin, Heidi S Harvie, Uduak U Andy","doi":"10.1007/s00192-025-06126-w","DOIUrl":"https://doi.org/10.1007/s00192-025-06126-w","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Early postpartum specialist care may improve outcomes for birthing people who sustain obstetric anal sphincter injuries (OASIS). This study was aimed at describing follow-up rates in a postpartum recovery clinic (PPRC) for patients who sustained OASIS at delivery, and at identifying factors associated with failure to follow up. We hypothesized that providing care in PPRC would result in high rates of access to specialized care for OASIS.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients with OASIS at a single institution from January 2018 to December 2023. Patients who sustain OASIS receive an automatic referral to PPRC within 3 weeks postpartum. Demographic and follow-up data were extracted from the medical records, including Edinburgh Postpartum Depression Scale (EPDS) score. The primary outcome was follow-up in PPRC. We examined associations between patient characteristics and failure to follow up using univariable and multivariable logistic regression.</p><p><strong>Results: </strong>Among 659 deliveries with OASIS during the study period, 540 (81.9%) followed up in a PPRC and of those 468 (86.7%) followed up within 3 weeks. Failure to follow up was associated with multiparity, Black race, Hispanic ethnicity, having Medicaid or state insurance, and elevated EPDS score on univariable analysis. On multivariable analysis, having Medicaid or state medical assistance and elevated depression screening remained associated with failure to follow up in a PPRC.</p><p><strong>Conclusions: </strong>There was a high overall attendance rate at a urogynecologist-led postpartum clinic in birthing people who sustained OASIS. An elevated depression screening score and having Medicaid or state medical assistance were associated with failure to follow up.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980481","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":"Intraoperative and Postoperative Complications Rate Following Elective Pelvic Reconstructive Surgery in Women with Severe Obesity: A Retrospective Cohort Study.","authors":"Alireza Hadizadeh, Henry Chill, Angela Leffelman, Claudia Paya-Ten, Cecilia Chang, Jungeun Lee, Roger P Goldberg, Ghazaleh Rostaminia","doi":"10.1007/s00192-025-06124-y","DOIUrl":"https://doi.org/10.1007/s00192-025-06124-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>To assess early intraoperative and postoperative complications and outcomes in patients with severe obesity undergoing apical prolapse repair compared with patients with normal weight.</p><p><strong>Methods: </strong>This retrospective cohort study included 315 patients who underwent apical prolapse repair at a tertiary medical center between 2009 and 2024. Fifty-six patients had a BMI greater than 40, and 259 had a normal BMI (18.5-30). Patients with class I and II obesity were excluded from the study. Preoperative data, surgical details, and 30-day postoperative complications were collected and analyzed.</p><p><strong>Results: </strong>The average age of the patients with severe obesity was significantly lower than that of patients with normal weight (56.6 vs 64.1 years, p < 0.001). Patients with severe obesity had a higher prevalence of diabetes (27.3% vs 9.0%, p < 0.001), hypertension (54.5% vs 25.1%, p < 0.001), and obstructive sleep apnea (21.8% vs 7.4%, p = 0.001). Intraoperatively, the group with severe obesity experienced greater estimated blood loss (233.6 ml vs 115.2 ml, p < 0.001) and were more likely to undergo concurrent incontinence procedures (76.4% vs 51.3%, p = 0.001). However, no significant difference in intraoperative complications was observed between the groups (5.4% vs 5.4%, p = 1.000). Hospitalization duration was longer in patients with morbid obesity. Total complication rate within 30 days was 7.3%, with no statistically significant difference between the groups with severe obesity and normal weight.</p><p><strong>Conclusion: </strong>Patients with severe obesity undergoing vaginal apical prolapse repair have similar rates of early postoperative complications and health care encounters to patients with normal weight. These findings support offering prolapse surgery to patients with morbid obesity when clinically indicated.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811441","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":"Development of a Maternal Health Care Exercise and Pelvic Abdominal Rehabilitation Curriculum for Obstetric Medical Professionals Using a Modified Delphi Process.","authors":"Zhaoying Chen, Shijie Huang, Fengming Hao, Ling Chen, Wei Ren, Wenzhi Cai","doi":"10.1007/s00192-025-06125-x","DOIUrl":"https://doi.org/10.1007/s00192-025-06125-x","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>The purpose of this study was to develop a maternal health care exercise and pelvic abdominal rehabilitation curriculum for obstetric medical professionals. Maternal health care exercise and pelvic abdominal rehabilitation can effectively prevent and alleviate pelvic-floor-rehabilitation problems in pregnant women and improve their quality of life. However, there is a lack of standardized courses for training obstetric medical professionals.</p><p><strong>Methods: </strong>This study used the Delphi method to design two rounds of expert consultation. A group of 17 specialists from the fields of gynecology, obstetrics, and rehabilitation, who are involved in clinical teaching and management, participated in the study. Data were collected between October and December 2023.</p><p><strong>Results: </strong>The effective recovery rates of the two rounds of questionnaires were 85.0% and 94.1%. The expert-authority coefficients were 0.90 and 0.88. The Kendall coordination coefficient was 0.35-0.41. The average importance score for each index ranged from 3.25 to 4.94. The coefficient of variation for each index ranged from 0.07 0.20. Based on the curricular topics, we constructed four first-level indicators, 16 second-level indicators, and 58 third-level indicators of exercise and pelvic and abdominal rehabilitation for obstetric medical professionals.</p><p><strong>Conclusion: </strong>The training curriculum provides obstetric medical professionals with the basis for obstetric rehabilitation. The training system is clear and coherent, and the content is clear and comprehensive, which enriches global obstetrical rehabilitation education resources. It is helpful to guide and educate on maternal obstetric rehabilitation to improve the quality of life of the women.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811438","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":"Impact of Type and Duration of Oral Antibiotic Prophylaxis on Urinary-Tract Infection Rate After Botox.","authors":"Bayley Clarke, Gabriella Yacovone, JooHee Choi, Joanna Marantidis, Marguerite Furlong, Alexis A Dieter","doi":"10.1007/s00192-025-06121-1","DOIUrl":"https://doi.org/10.1007/s00192-025-06121-1","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Urinary tract infection (UTI) is common after onabotulinumtoxin A intradetrusor injections (BTX) but no evidenced-based recommendations exist to guide prophylactic antibiotic regimen. We sought to compare the effect of different oral antibiotic prophylaxis in women with idiopathic and neurogenic overactive bladder (OAB) undergoing BTX.</p><p><strong>Methods: </strong>This was a single-center retrospective cohort study of women >18 years old who underwent BTX for OAB between June 2018 and June 2023. Duration and type of antibiotic prophylaxis at time of BTX injection were recorded. Primary outcome was treatment for symptomatic UTI within 30 days.</p><p><strong>Results: </strong>A total of 1250 procedures were included. UTI rate within 30 days of BTX injection was 10% (n = 125). Duration of antibiotics (1 day, 3 days, 5 days, versus ≥7 days of treatment) did not affect 30-day UTI rate (p = 0.42). When comparing antibiotic type, nitrofurantoin had the lowest UTI rate at 8.7% while trimethoprim/sulfamethoxazole (TMP-SMX) had a rate of 12.3% and \"other\" had highest at 32.4% (p< 0.01). Retreatment rate for UTI was low at 1.9% and urine cultures showed low resistance rates (1.8%) but TMP-SMX had the highest rate of resistance at 4.6% (p < 0.01). There were no differences in retreatment rate or resistance rate between the different durations of prophylactic antibiotics (p>0.05 for both).</p><p><strong>Conclusions: </strong>The UTI rate after onabotulinumtoxin A injections was similar regardless of the duration of prophylactic antibiotic use. Nitrofurantoin and TMP-SMX had the lowest 30-day UTI rates. These data provide compelling evidence in support of 1-day prophylactic antibiotic treatment regimens with nitrofurantoin (or TMP-SMX) for women with OAB undergoing BTX injection.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795582","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":"Long-Term Outcomes Following Vaginal versus Laparoscopic Uterosacral Ligament Suspension.","authors":"Sarah Sears, Megan Abrams, Kasey Palm, Susan Wherley, Robert Pollard, Jeffrey Mangel, David Sheyn","doi":"10.1007/s00192-025-06132-y","DOIUrl":"https://doi.org/10.1007/s00192-025-06132-y","url":null,"abstract":"<p><strong>Introduction and hypothesis: </strong>Long-term outcomes following vaginal (V-USLS) versus laparoscopic (L-USLS) uterosacral ligament suspension have not been reported in the literature. Our objective was to compare long-term outcomes following V-USLS versus L-USLS following hysterectomy.</p><p><strong>Methods: </strong>This was an ambispective cohort study at a single academic institution comparing patients who underwent a V-USLS following a vaginal hysterectomy or L-USLS following a laparoscopic hysterectomy from 2013 to 2018. The primary outcome was composite prolapse recurrence rate, combining subjective prolapse symptoms and objective failure, including prolapse beyond the hymen on pelvic organ prolapse quantification exam or retreatment. A power calculation determined 68 patients in each group would be required to detect a difference of 15% in recurrence rates. Statistical analysis was performed using Student' t-test, Wilcoxon rank sum test, chi-square test, or Fishers exact test, and multivariable logistic regression where appropriate.</p><p><strong>Results: </strong>Thirty-six patients in each group presented for a study visit. Preoperative POP-Q measurements were similar between groups. Surgical complication rates were low and similar between groups. Mean follow-up time was 6.8 years, similar between groups. V-USLS had higher rates of recurrent prolapse beyond the hymen on POP-Q (33.2% vs 11.1%, p = 0.016), retreatment (25.0% vs 2.8%, p = 0.006), and composite failure (47.2% vs 22.2%, p = 0.019). Subjective prolapse symptoms were similar between groups. V-USLS was associated with a higher risk of prolapse recurrence (aOR 1.73 (95%CI 1.13-5.78). Anterior prolapse (Aa) was associated with higher recurrence risk, with aOR 2.04 (95%CI 1.15-3.62) per every 1 cm, up to 3 cm beyond the hymen.</p><p><strong>Conclusions: </strong>On the basis of these results, L-USLS appears to have a decreased association with recurrence compared to V-USLS. Conclusions are limited by a small sample size.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763619","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 Problem of Recurrent Anterior Wall Prolapse after Supracervical Hysterectomy with Sacrocolpopexy.","authors":"Amr S El Haraki, Andre R Plair, Catherine A Matthews","doi":"10.1007/s00192-025-06134-w","DOIUrl":"https://doi.org/10.1007/s00192-025-06134-w","url":null,"abstract":"<p><p>This video details a step-by-step approach to sacrocolpopexy for recurrent anterior vaginal vault prolapse following a sacrocolpopexy at the time of supracervical hysterectomy. An explanation regarding the etiology of increased incidence of recurrent pelvic organ prolapse in supracervical hysterectomy with concomitant sacrocolpopexy as compared to total hysterectomy is provided. Minimally invasive sacrocolpopexy is a feasible and safe option for the treatment of recurrent vaginal vault prolapse. Recurrence of prolapse following pelvic reconstruction most commonly occurs in the anterior compartment. Studies have shown that supracervical hysterectomy at the time of sacrocolpopexy increases the risk of recurrent prolapse compared to total hysterectomy. While supracervical hysterectomy at time of sacrocolpopexy decreases incidence of mesh exposure, careful consideration should be given to patients with redundant anterior vaginal prolapse and patients who have more advanced pelvic organ prolapse preoperatively. This may entail performing a total hysterectomy in lieu of a supracervical hysterectomy or plicating the anterior vaginal wall to decrease redundancy and potentially recurrence of prolapse of the anterior compartment.</p>","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763556","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":"Comment on \"Short-Term Complications of Concomitant Pelvic Organ Prolapse and Rectal Prolapse Repair: A Systematic Review and Meta-Analysis\".","authors":"Shubham Kumar, Nosaibah Razaqi, Rachana Mehta, Ranjana Sah","doi":"10.1007/s00192-025-06066-5","DOIUrl":"10.1007/s00192-025-06066-5","url":null,"abstract":"","PeriodicalId":14355,"journal":{"name":"International Urogynecology Journal","volume":" ","pages":"939-940"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005138","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}