International journal of surgery最新文献

{"title":"Evaluating the learning curve for flexible ureteroscopic thulium fiber laser lithotripsy using CUSUM analysis.","authors":"Zhilong Li, Shaojie Wu, Xiaoyu Tang, Yongwen Luo, Du Wang, Tongzu Liu, Sheng Li, Xinghuan Wang","doi":"10.1097/JS9.0000000000002246","DOIUrl":"10.1097/JS9.0000000000002246","url":null,"abstract":"<p><strong>Objectives: </strong>Effective training methods and learning curve (LC) assessment are crucial for more difficult endoscopic procedures. The present study sought to assess the LC of flexible ureteroscopes (fURS) for thulium fiber laser (TFL) lithotripsy and determine the effectiveness of using a porcine kidney model in training modality, to inform future training.</p><p><strong>Methods: </strong>Postgraduate medical students without experience in ureteroscopy were recruited, and surgical data were collected from 10 consecutive flexible ureteroscopic lithotripsy (fURL) procedures performed on our homemade porcine kidney training model. Cumulative sum (CUSUM) analysis and pooled mean CUSUM curves were applied to determine the LC turning points (TPs), and pre-LC and post-LC data were compared with that of an experienced attending physician.</p><p><strong>Results: </strong>Data from 110 surgeries were included in the analysis. The mean number of surgical units to overcome the LC for the duration of fURS TFL lithotripsy was 4. The operation time, number of tissue damage, and number of central visual shifts were significantly lower in students after the TP than before. No statistically significant difference in operation time was found between the students after the LC (817.50 [703.75-964.75]) and the surgeon group (732.50 [51.00-822.25]).</p><p><strong>Conclusion: </strong>Overcoming the LC of fURS TFL lithotripsy requires four surgeries, and the developed ex vivo porcine kidney is a conveniently accessible and effective clinical training model.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2430-2438"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovative logic \"AND\" gate gene circuits for bladder cancer treatment: preclinical study.","authors":"Chaojie Xu, Ying Dong, Dongchen Pei, Xintao Zhang, Xiaohong Han, Congcong Cao, Baorui Wu, Changning Lv, Zhengjun Kang, Liqun Zhou, Yuchen Liu, Lin Yao","doi":"10.1097/JS9.0000000000002270","DOIUrl":"10.1097/JS9.0000000000002270","url":null,"abstract":"<p><p>In the evolving field of precision oncology, the synthesis of gene circuits that specifically target cancer cells while preserving normal tissue marks a significant breakthrough. However, traditional approaches typically concentrate on single-gene targets, lacking the directed recognition and control among the intricate networks of signaling pathways. Our study presents a synthetic gene circuit, the Logic \"AND\" Gate Dual-Target Genetic Circuit (LAG-DTGC), which integrates multiple signals to achieve comprehensive reprogramming of various signaling pathways in bladder cancer (BC) cells. This circuit's development hinged on detailed bioinformatics analysis, pinpointing more unique biomarkers with similar expression pattern in BC. LAG-DTGC is engineered to selectively activate in cells where these biomarkers are abnormally expressed. Its precision and the remodeling cell behavior capability are further enhanced by incorporating a logic \"AND\" gate, triggering the circuit only in the presence of these aberrant cancer-specific biomarkers. LAG-DTGC exhibits an extraordinary ability to reprogram cancer cell signaling pathways, turning the cells' own mechanisms against them for therapeutic effect. This work highlights the potential of synthetic biology in developing precise, less toxic treatments for BC. The LAG-DTGC represents a promising new paradigm in cancer therapy.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2735-2751"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The incidence and outcomes of hyperacute cardiovascular dysfunction following isolated traumatic brain injury: an observational cohort study.","authors":"Flora Bird, Mark Wilson, Shadman Aziz, Moustafa Shebl, Alexander Pickard, David Sims, Gareth Grier, David Lockey, Ross Davenport","doi":"10.1097/JS9.0000000000002266","DOIUrl":"10.1097/JS9.0000000000002266","url":null,"abstract":"<p><strong>Background: </strong>The relationship between early cardiovascular dysfunction (CVD) in isolated traumatic brain injury (iTBI) and outcome has not been fully described. We aimed to (1) determine the prevalence and phenotype of CVD after iTBI in the hyper-acute phase and (2) compare treatment and outcomes in those with CVD vs non-CVD.</p><p><strong>Methods: </strong>An observational cohort database study of severe iTBI patients (Head AIS 3+) at a level 1 trauma centre (2008-2019) and physician-led air ambulance service (2019-2020). CV dysfunction was defined as tachycardia or bradycardia, with hypotension. Physiology, laboratory results, 24-hour transfusion, and computer-topography (CT) findings were recorded. Outcomes were 28-day mortality and Glasgow Outcome Score (GOS).</p><p><strong>Results: </strong>A total of 168 patients met inclusion criteria, average age 46 years (IQR 30-61), 77% male, median ISS 25 (IQR 17-29) with 51% Head AIS 5. Time from injury to pre-hospital assessment was 31 minutes (IQR 20-42) with 20% demonstrating CVD on initial observations. The CVD group were more shocked (lactate 6.1 (1.7-10.9) vs. 2.4 (1.4-3.3), P < 0.001) and coagulopathic (43% vs. 15%, P = 0.001). There was no difference in Head AIS or CT findings between groups, except frequency of hypoxic ischemic encephalopathy (HIE) (CVD: 21% vs. non-CVD: 1%, P < 0.001). 24-hour transfusion was higher in CVD patients: 3 (0-8) vs. 0 (0-0) units, P < 0.001. Mortality was greater in CVD vs non-CVD iTBI (61% vs. 31%, P = 0.002), but in patients with AIS 5 there was no difference ( P = 0.262). One-third of CVD survivors (13/33) were discharged home, and 4/18 patients with recorded GOS had good neurological outcome.</p><p><strong>Conclusion: </strong>One in five patients with severe iTBI develop early CVD, associated with increased mortality, coagulopathy, and HIE. However, mortality and neurological outcome is highly variable in those with CVD across the iTBI severity spectrum. Further research is needed to define the pathophysiology and optimal treatment to improve outcomes for this subgroup of iTBI.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2516-2524"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence-assisted precise preoperative prediction of lateral cervical lymph nodes metastasis in papillary thyroid carcinoma via a clinical-CT radiomic combined model.","authors":"Junze Du, Xingyun He, Rui Fan, Yi Zhang, Hao Liu, Haoxi Liu, Shangqing Liu, Shichao Li","doi":"10.1097/JS9.0000000000002267","DOIUrl":"10.1097/JS9.0000000000002267","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to develop an artificial intelligence-assisted model for the preoperative prediction of lateral cervical lymph node metastasis (LCLNM) in papillary thyroid carcinoma (PTC) using computed tomography (CT) radiomics, providing a new noninvasive and accurate diagnostic tool for PTC patients with LCLNM.</p><p><strong>Methods: </strong>This retrospective study included 389 confirmed PTC patients, randomly divided into a training set ( n = 272) and an internal validation set ( n = 117), with an additional 40 patients from another hospital as an external validation set. Patient demographics were evaluated to establish a clinical model. Radiomic features were extracted from preoperative contrast-enhanced CT images (venous phase) for each patient. Feature selection was performed using analysis of variance and the least absolute shrinkage and selection operator algorithm. We employed support vector machine, random forest (RF), logistic regression, and XGBoost algorithms to build CT radiomic models for predicting LCLNM. A radiomics score (Rad-score) was calculated using a radiomic signature-based formula. A combined clinical-radiomic model was then developed. The performance of the combined model was evaluated using the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).</p><p><strong>Results: </strong>A total of 1724 radiomic features were extracted from each patient's CT images, with 13 features selected based on nonzero coefficients related to LCLNM. Four clinically relevant factors (age, tumor location, thyroid capsule invasion, and central cervical lymph node metastasis) were significantly associated with LCLNM. Among the algorithms tested, the RF algorithm outperformed the others with five-fold cross-validation on the training set. After integrating the best algorithm with clinical factors, the areas under the ROC curves for the training, internal validation, and external validation sets were 0.910 (95% confidence interval [CI]: 0.729-0.851), 0.876 (95% CI: 0.747-0.911), and 0.821 (95% CI: 0.555-0.802), respectively, with DCA demonstrating the clinical utility of the combined radiomic model.</p><p><strong>Conclusions: </strong>This study successfully established a clinical-CT radiomic combined model for predicting LCLNM, which may significantly enhance surgical decision-making for lateral cervical lymph node dissection in patients with PTC.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2453-2466"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of a submucosal and subserosal approach in ICG-guided laparoscopic lymphadenectomy in gastric cancer patients: long-term outcomes of a phase 3 randomized clinical trial.","authors":"Qing Zhong, Zhi-Xin Shang-Guan, Zhi-Yu Liu, Dong Wu, Ze-Ning Huang, Hua-Gen Wang, Jun-Yun Chen, Jin-Xun Wu, Ping Li, Jian-Wei Xie, Chao-Hui Zheng, Qi-Yue Chen, Chang-Ming Huang","doi":"10.1097/JS9.0000000000002271","DOIUrl":"10.1097/JS9.0000000000002271","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have demonstrated similar short-term efficacy between subserosal (SSA) and submucosal (SMA) approaches for ICG injection in gastric cancer (GC). This study aims to compare the long-term oncological outcomes of these two injection methods for lymph node (LN) tracing in ICG-guided laparoscopic gastrectomy.</p><p><strong>Materials and methods: </strong>This study was a phase 3, open-label, randomized clinical trial (FUGES-019). A total of 266 patients with resectable gastric adenocarcinoma (cT1-4a, N0/ +, M0) were enrolled. We report predefined long-term secondary outcomes, including three-year actual overall survival (OS), three-year actual disease-free survival (DFS), and recurrence patterns.</p><p><strong>Results: </strong>Of the 266 participants, 259 patients were included in the per-protocol analysis: 129 in the SSA group and 130 in the SMA group. The actual OS in the SSA group (87.6%) was comparable to that in the SMA group (90.8%, P = 0.41), as were the 3-year actual DFS rates (SSA: 82.9% vs. SMA: 88.5%, log-rank P = 0.19). Per-protocol analysis confirmed the equivalence of the SSA compared with the SMA. The most common type of recurrence was multiple site metastasis (11 of 259[4.24%]), with no differences in recurrence types across cancer stages. Further stratified analysis based on pT, pN staging, tumor size, and BMI showed no significant differences between the two groups.</p><p><strong>Conclusion: </strong>The 3-year outcomes of the FUGES-019 trial confirm the equivalence of SSA and SMA in ICG-guided laparoscopic lymphadenectomy for GC, supporting the previous short-term findings. The subserosal approach can be recommended for ICG administration based on clinical considerations.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2558-2569"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing predictive nomogram models using quantitative electroencephalography for brain function in type a aortic dissection: a prospective observational study.","authors":"Ya-Peng Wang, Yi Jiang, Lin Mi, Wen-Xue Liu, Yun-Xing Xue, Yang Chen, Xuan Luo, Yong-Qing Cheng, Jun Pan, Jason Zhensheng Qu, Dong-Jin Wang","doi":"10.1097/JS9.0000000000002235","DOIUrl":"10.1097/JS9.0000000000002235","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Type A aortic dissection (TAAD) remains a significant challenge in cardiac surgery, presenting high risks of adverse outcomes such as permanent neurological dysfunction and mortality despite advances in medical technology and surgical techniques. This study investigates the use of quantitative electroencephalography (QEEG) to monitor and predict neurological outcomes during the perioperative period in TAAD patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This prospective observational study was conducted at the hospital, involving patients undergoing TAAD surgery from February 2022 to January 2023. QEEG parameters, including the dynamic amplitude-integrated electroencephalography (aEEG) grade, which assesses changes in brain function over time, alongside aEEG and relative band power (RBP), were monitored and analyzed to assess brain function preoperatively, intraoperatively, and within 2 hours postoperatively. A predictive nomogram model was developed using these QEEG metrics along with other clinical variables to forecast neurological outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In this study, we analyzed the factors contributing to adverse outcomes (AO) and transient neurological dysfunction (TND) following TAAD surgery. For AO, multivariable analysis identified pre-mental status (odds ratio [OR] = 4.652, 95% confidence interval [CI] = 2.316-10.074, P &lt; 0.001), cardiopulmonary bypass time (OR = 1.014, 95% CI = 1.006-1.023, P = 0.001), and dynamic aEEG grade (OR = 9.926, 95% CI = 4.493-25.268, P &lt; 0.001) as independent risk factors. The AO model showed high discriminative ability with an area under the curve of 0.888 (95% CI = 0.818-0.960) and good calibration (Brier score = 0.0728). For TND, significant preoperative differences included dynamic aEEG grade ( P &lt; 0.001) and Log(Post-RBP Alpha%) (6.00 vs. 4.00, P &lt; 0.001). Multivariable analysis identified cardiopulmonary bypass time (OR = 1.014, 95% CI = 1.006-1.023, P = 0.001), Post-RBP Alpha% (OR = 0.263, 95% CI = 0.121-0.532, P &lt; 0.001), and dynamic aEEG grade (OR = 12.444, 95% CI = 5.337-30.814, P &lt; 0.001) as independent risk factors. The TND model had an area under the curve of 0.893 (95% CI = 0.844-0.941) and good calibration (Brier score = 0.125). These findings highlight the role of QEEG in predicting postoperative neurological dysfunction in TAAD patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Through perioperative QEEG monitoring of TAAD patients, combined with clinical indicators such as cardiopulmonary bypass time and preoperative mental status, we developed clinical predictive models for AO and TND after surgery. These models allow for early detection of postoperative brain function impairment, as assessed by QEEG parameters monitored intraoperatively and during the first 2 hours after surgery, a period chosen based on clinical definitions of delayed awakening and supported by the findings of this study. This study provides evidence supporting postoperative brain f","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2398-2413"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal oculomics and risk of incident aortic aneurysm and aortic adverse events: a population-based cohort study.","authors":"Cong Li, Yu Huang, Jian Chen, Guangyao Hua, Fan Yang, Dongqin Cai, Yu Kuang, Xue He, Yan Wang, Jianrong Jiang, Zhenchao Du, Jingyan Peng, Heng Li, Zhishen Peng, Tengda Huang, Yun Ren, Wenli Zhang, Lei Liu, Danli Shi, Jianfang Luo, Honghua Yu, Xiaohong Yang","doi":"10.1097/JS9.0000000000002236","DOIUrl":"10.1097/JS9.0000000000002236","url":null,"abstract":"<p><strong>Background: </strong>The asymptomatic onset and extremely high mortality rate of aortic aneurysm (AA) highlight the urgency of early detection and timely intervention. The alteration of retinal vascular features (RVFs) can reflect the systemic vascular properties, and be widely used as the biomarker for cardiovascular disease risk prediction. Therefore, we aimed to investigate associations of RVFs with AA and its progression.</p><p><strong>Methods: </strong>In this prospective population-based cohort study, participants with eligible fundus images and without a history of AA at recruitment were included for analysis. A fully automated Retina-based Microvascular Health Assessment System was used to quantify multidimensional RVFs including the branching angle, caliber, complexity, density, length, and tortuosity. Univariable and multivariable Cox regressions were used to estimate the association of RVFs with the incidence of AA and aortic adverse events (AAE). Furthermore, propensity score matching was performed to mitigate the confounding effects of baseline characteristics.</p><p><strong>Results: </strong>During a median follow-up of 11.0 years, 306 incident AA (164 with abdominal AA and 108 with thoracic AA) and 48 incident AAE were documented. In the fully adjusted model, the retinal arterial branching angle (hazard ratio [HR] 0.87, 95% confidence interval [CI] 0.77 to 0.99) and the central tendency and variability of minimum venular caliber were significantly associated with the risk of incident AA (HR 1.13-1.15), while the venular minimum angular asymmetry (0.48, 0.30 to 0.77) was significantly associated with the incidence of AAE. Moreover, specific alterations of RVFs were observed in different AA subtypes (caliber in abdominal AA [HR 1.21]; caliber [HR 1.21-1.28], complexity, length, and tortuosity [HR 0.77-0.82] in thoracic AA). Similar results were obtained after propensity score-matched analysis, confirming the stability of these associations.</p><p><strong>Conclusions: </strong>We identified a significant association of certain RVFs with incident AA and AAE, implying that noninvasive, and convenient fundus photography could be a promising tool to facilitate the early detection of AA and subsequent preventative interventions.</p>","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2478-2486"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and considerations of DNA methylation markers in peripheral blood mononuclear cells for early screening of lung adenocarcinoma.","authors":"Rong Fu, Huijie Li, Xiurong Li","doi":"10.1097/JS9.0000000000002245","DOIUrl":"10.1097/JS9.0000000000002245","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2759-2760"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: \"A systematic review and network meta-analysis comparing upfront surgery with neoadjuvant treatments in pancreatic cancer\".","authors":"Qiang Yi, Gangfeng Zhu, Jinghua Zhong","doi":"10.1097/JS9.0000000000002226","DOIUrl":"10.1097/JS9.0000000000002226","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":" ","pages":"2757-2758"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between cataract surgery and mental health in older adults: a review: Erratum.","authors":"","doi":"10.1097/JS9.0000000000002320","DOIUrl":"https://doi.org/10.1097/JS9.0000000000002320","url":null,"abstract":"","PeriodicalId":14401,"journal":{"name":"International journal of surgery","volume":"111 3","pages":"2764"},"PeriodicalIF":12.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}