Japanese Journal of Ophthalmology最新文献

{"title":"Surgical safety and efficacy of a multi-stent system, the comet stent, in Baerveldt glaucoma implant surgery: a prospective pilot study.","authors":"Shin-Ichi Manabe, Akira Hirata, Tadamichi Akagi, Ken Hayashi","doi":"10.1007/s10384-023-01014-6","DOIUrl":"10.1007/s10384-023-01014-6","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to introduce a new technique for lowering intraocular pressure (IOP) using a multi-stent system after the implantation of a Baerveldt glaucoma implant (BGI) and evaluate its clinical effectiveness.</p><p><strong>Study design: </strong>Prospective case series.</p><p><strong>Methods: </strong>Six patients with uncontrolled refractory glaucoma were enrolled between December 2021 and May 2022. Six 6-0 nylon sutures were preoperatively inserted into the tube of a BGI. These sutures were named \"comet stents\" (CSs). BGI implantation was performed, and the CSs were removed one-by-one whenever the IOP rose during the follow-up period. IOP was measured 30-60 min after the removal of each CS, and the reduction in IOP was recorded to assess the effect of CS removal. IOP reduction and the effect of CS removal on IOP reduction were evaluated for 6 months. The cut and trimmed stented tubes were examined with scanning electron microscopy, and the ratio of the patent cross-sectional area to the total luminal area (PCSA, %) and the luminal area occupation rate per stent (%) were calculated.</p><p><strong>Results: </strong>The mean (±standard deviation) IOP decreased from 31.5 ± 2.8 mmHg at the baseline to 14.8 ± 8.3 mmHg at 1 month, 8.8 ± 4.7 mmHg at 3 months, and 9.2 ± 3.4 mmHg at 6 months. The IOP reduction induced by CS removal ranged from 0 to 19 mmHg. The mean PCSA was 52.7 ± 1.7%, and the mean luminal area occupation rate per stent was 7.9 ± 0.3%.</p><p><strong>Conclusion: </strong>The use of CSs is an effective technique for controlling IOP in a step-by-step manner after BGI surgery.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935398","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":"Customization of a passive surgical support robot to specifications for ophthalmic surgery and preliminary evaluation.","authors":"Soichiro Yamamoto, Yohei Kuroki, Toshihiro Ide, Shin Tanaka, Rintaro Hirahara, Ayako Takamori, Tomohisa Nishimura, Kiyoshi Suzuma, Kazuaki Kadonosono, Hiroshi Enaida","doi":"10.1007/s10384-023-01017-3","DOIUrl":"10.1007/s10384-023-01017-3","url":null,"abstract":"<p><strong>Purpose: </strong>To customize a passive surgery support robot for ophthalmic surgery and preliminarily evaluate its performance.</p><p><strong>Study design: </strong>Prospective observational study.</p><p><strong>Methods: </strong>The range of motion of the arm was analyzed during ophthalmic surgery and, based on this analysis, a commercially available passive robot was customized for surgical support for ophthalmic surgery; following which a prototype robot was constructed. To examine the effects on the brachial muscle during surgical operations with and without the prototype robot, surface electromyograms of the biceps and triceps were analyzed after performing continuous curvilinear capsulorrhexis (CCC) and suturing the sclerocorneal wound in a cataract surgery simulation. Six surgeons performed cataract surgery, and the degree of arm stability and muscle fatigue during surgery were evaluated using a visual analog scale.</p><p><strong>Results: </strong>During surgery, the prototype robot enabled fixation of the elbow and wrist at any position within the surgeon's range of motion, expanding the range of motion of the hand and fingers and stabilizing operability. Surface electromyography showed a significant decrease in the mean amplitude value of the biceps brachii during both CCC and suturing (p < 0.0001). No significant difference was observed in the triceps brachii. The arm stability and muscle fatigue were improved by 83.3% on the visual analog scale with the prototype robot compared with that without protpotype robot.</p><p><strong>Conclusion: </strong>The use of a passive prototype robot may improve arm stability and reduce muscle fatigue during ophthalmic surgery.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10339171","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":"Periocular methotrexate versus periocular triamcinolone injections for active thyroid-associated orbitopathy: a randomized clinical trial.","authors":"Islam Y Swaify, Haytham E Nasr, Rania A El Essawy, Kareem B Elessawy","doi":"10.1007/s10384-023-01016-4","DOIUrl":"10.1007/s10384-023-01016-4","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy and safety of periocular injections of methotrexate versus triamcinolone in the management of active thyroid-associated orbitopathy.</p><p><strong>Study design: </strong>Prospective, double-masked, randomized clinical trial.</p><p><strong>Methods: </strong>Participants with bilateral active, moderate-to-severe thyroid-associated orbitopathy were randomly assigned to receive three periocular injections of 7.5 mg methotrexate in one orbit and three periocular injections of 20 mg triamcinolone in the contralateral orbit.</p><p><strong>Results: </strong>Among the enrolled 25 patients, 18 patients completed the study. A statistically significant reduction of the mean clinical activity score was detected in both arms (from 5.2 ± 0.89 at baseline to 0.9 ± 1.7 at study endpoint, p-value < 0.001 in the methotrexate arm, and from 5.1 ± 0.9 at baseline to 1 ± 1.7 at study endpoint, p-value < 0.001 in the triamcinolone arm), mean proptosis also decreased in both arms (from 25.2 ± 3.4 mm at baseline to 23.8 ± 3.7 mm at study endpoint, p-value = 0.01 in the methotrexate arm, and from 24.2 ± 3.06 mm at baseline to 23.2 ± 3.3 mm at study endpoint, p-value = 0.049 in the triamcinolone arm). Lid aperture and soft tissue signs improved significantly in both arms in comparison to baseline. A statistically significant reduction in the intraocular pressure was observed in the methotrexate arm but not in the triamcinolone arm. 88.9% of patients in both arms were overall responders at 6 months. There was no significant difference in mean CAS, proptosis, lid aperture or rate of responders between the two arms at any visit. Both drugs were found to be safe with minimal local and systemic complications.</p><p><strong>Conclusion: </strong>Periocular injections of methotrexate represent an effective and safe alternative option for the management of active, moderate-to-severe thyroid-associated orbitopathy. Although no serious complications occurred during the 6-month follow-up, the possibility of late complications such as orbital fat atrophy cannot be ruled out.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9935396","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":"Correction to: A novel instrument to determine hue discrimination.","authors":"Mitsuru Sawa, Masaharu Mizuochi, Kazunori Matsumura, Makoto Aihara, Satoru Yamagami, Hidetoshi Yamashita, Toshikatsu Kaburaki","doi":"10.1007/s10384-023-01019-1","DOIUrl":"10.1007/s10384-023-01019-1","url":null,"abstract":"","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10032172","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":"Lens factor as an underlying mechanism in primary angle closure with gonioscopically-visualized ciliary body processes.","authors":"Hatice Tekcan, Mehmet Serhat Mangan, Gökhan Celik, Serhat Imamoglu","doi":"10.1007/s10384-023-01021-7","DOIUrl":"10.1007/s10384-023-01021-7","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the differences in anterior segment parameters between eyes with primary angle closure (PAC) with and without gonioscopically-visualized ciliary body processes (CBP).</p><p><strong>Study design: </strong>Prospective, observational, comparative clinical study.</p><p><strong>Methods: </strong>Detailed ocular examinations and gonioscopy were performed in 89 eyes of 89 patients with PAC to determine the visibility of the CBP. Anterior chamber depth (ACD), anterior chamber width, lens thickness (LT), lens vault (LV) and pupil diameter were determined using ultrasound biomicroscopy. The lens-axial length factor (LAF) and relative lens position (RLP) were calculated. All parameters were compared between eyes with and without gonioscopically visible CBP (PAC+CBP and PAC-CBP groups) after adjusting for age and gender. The association of the parameters with visible CBP was analyzed by univariate logistic regression analysis.</p><p><strong>Results: </strong>PAC+CBP group included 41 eyes and the PAC-CBP group, 48 eyes. The axial length and ACD were statistically significantly smaller (p = 0.009 and p = 0.005, respectively) and LT, LV and LAF were statistically significantly greater (p = 0.03, p = 0.008 and p = 0.004, respectively) in the PAC+CBP group. In the PAC eyes with glaucoma, the LT, LV and LAF were statistically significantly greater in the PAC+CBP group (p = 0.02, p = 0.001 and p = 0.02, respectively). The LAF had the strongest association with visible CBP in the regression analysis (Odds ratio = 141.70, p = 0.002).</p><p><strong>Conclusion: </strong>Gonioscopical visualization of ciliary processes may suggest that anterior segment crowding, especially lens factor is the underlying mechanism in PAC. It may provide a practical gonioscopic examination method for predicting the predominant pathophysiology of PAC.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10028528","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":"Persistence of the carteolol hydrochloride/latanoprost fixed-combination ophthalmic solution, compared with the other β-blocker/prostanoid FP receptor agonist fixed-combination ophthalmic solutions.","authors":"Kenji Kashiwagi, Kentaro Ouchi, Yoshiyuki Shibasaki, Masaki Suginaka","doi":"10.1007/s10384-023-01020-8","DOIUrl":"10.1007/s10384-023-01020-8","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the treatment persistence of carteolol hydrochloride/latanoprost fixed-combination ophthalmic solution (CAR/LAT) and other β-blocker/prostanoid FP receptor agonist fixed-combination ophthalmic solutions (BB/FP) in the treatment of glaucoma.</p><p><strong>Study design: </strong>Retrospective observational cohort study.</p><p><strong>Methods: </strong>A retrospective observational cohort study using JMDC Claims Database. Patients aged 20 years or older diagnosed with glaucoma between February 1, 2017, and March 31, 2020, and prescribed CAR/LAT or another BB/FP were included.</p><p><strong>Results: </strong>A total of 16,612 patients (7423 in the CAR/LAT group and 9189 in the other BB/FP group) were included. The cumulative treatment persistence rate at the end of follow-up was 42.0% (64.9% at 1 year, 53.4% at 2 years, 45.0% at 3 years, and 42.0% at 4 years) in the CAR/LAT group and 34.7% (54.8% at 1 year, 43.6% at 2 years, 37.1% at 3 years, and 34.7% at 4 years) in the other BB/FP group. Treatment persistence was significantly longer in the CAR/LAT group compared to that in the other BB/FP group (hazard ratio 0.747, p < 0.0001). Over the treatment period, the number of patients who discontinued treatment was 3281 (44.2%) in the CAR/LAT group and 4926 (53.6%) in the other BB/FP group; the median duration of treatment was 135 days and 97 days, respectively.</p><p><strong>Conclusion: </strong>The study results suggest that persistence rates vary depending on the BB/FP and CAR/LAT appears to be more persistent than other BB/FP.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10097144","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":"Additive effects of brimonidine tartrate 0.1%/brinzolamide 1% fixed-dose combination in prostaglandin analog-treated Japanese glaucoma patients.","authors":"Rei Sakata, Shiro Mizoue, Keiji Yoshikawa, Misato Adachi, Shinji Ohkubo, Naoki Hamada, Tomoko Naito, Tomoyuki Muramatsu, Takeshi Hara, Ryo Asato, Makoto Aihara","doi":"10.1007/s10384-023-01022-6","DOIUrl":"10.1007/s10384-023-01022-6","url":null,"abstract":"<p><strong>Purpose: </strong>A brimonidine tartrate 0.1%/brinzolamide 1% fixed-dose combination (BBFC) was recently approved for glaucoma and ocular hypertension treatment in Japan. We investigated the efficacy and safety of BBFC used concomitantly with prostaglandin analogs (PG) or a PG/beta-blocker fixed-dose combination (PG/beta FC).</p><p><strong>Study design: </strong>This was a prospective, open-label, multicenter study.</p><p><strong>Patients and methods: </strong>We enrolled Japanese patients with open-angle glaucoma. BBFC (Ailamide) was concomitantly administered to either the PG or the PG/beta FC group, and intraocular pressure (IOP) and safety were evaluated at 4 and 12 weeks. The groups were stratified into low and high IOP baseline groups based on the median baseline IOP.</p><p><strong>Results: </strong>We enrolled 100 patients, 91 of whom completed the 12-week follow-up. The mean ages were 67.1 and 65.7 years in the PG group (n = 45, baseline IOP of 15.7 ± 2.3 mmHg) and the PG/beta FC group (n = 46, baseline IOP of 16.3 ± 2.3 mmHg), respectively. After BBFC administration, IOPs at 4 and 12 weeks were 13.0 ± 2.0 and 13.0 ± 2.6 mmHg (P < 0.0001) in the PG group, respectively, and 13.7 ± 2.4 and 13.7 ± 2.2 mmHg (P < 0.0001) in the PG/beta FC group, respectively. IOP decreased by - 2.0 ± 1.8 mmHg (P < 0.0001) and -1.9 ± 1.4 mmHg (P < 0.0001) in the low baseline PG group (14.1 mmHg) and low baseline PG/beta FC group (14.8 mmHg) at 12 weeks, respectively. Sixteen adverse events were identified, all of which were common and did not affect visual acuity.</p><p><strong>Conclusions: </strong>BBFC can be used concomitantly with PG or PG/beta FC to reduce IOP without serious complications.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10028531","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":"Clinical presentations of acquired comitant esotropia in 5-35 years old Japanese and digital device usage: a multicenter registry data analysis study.","authors":"Hirohito Iimori, Sachiko Nishina, Osamu Hieda, Toshiaki Goseki, Noriko Nishikawa, Sadao Suzuki, Akiko Hikoya, Miwa Komori, Hiroko Suzuki, Tomoyo Yoshida, Shion Hayashi, Takafumi Mori, Akiko Kimura, Takeshi Morimoto, Yukiko Shimizu, Takashi Negishi, Tamami Shimizu, Yoshimi Yokoyama, Yoshiko Sugiyama, Noriyuki Azuma, Miho Sato","doi":"10.1007/s10384-023-01023-5","DOIUrl":"10.1007/s10384-023-01023-5","url":null,"abstract":"<p><strong>Purpose: </strong>To describe clinical presentations of acquired comitant esotropia and digital device use in children, adolescents, and young adults without neurological problems.</p><p><strong>Study design: </strong>Multicenter prospective observational study.</p><p><strong>Methods: </strong>Patients with acquired comitant esotropia, without intracranial diseases aged 5-35 years at the time of visit, who were seen at pre-registered facilities within 1 year of onset were enrolled. The duration from the onset of symptoms and the time of digital device usage approximately 1 month before onset and their lifestyles were surveyed. Visual acuity, cycloplegic refraction, and strabismus angles were measured. Data were analyzed in three age groups (Child: 5-12 years, Adolescent: 13-18 years, and Young adult: 19-35 years).</p><p><strong>Results: </strong>Between November 2019 and December 2021, 218 patients were enrolled from 55 facilities, and 194 patients (including 62 children, 69 adolescents, and 63 young adults) were analyzed. The child group spent the least amount of time using digital devices (children: 159; adolescents: 210; young adults: 267 min/work day, p < 0.05; (mean time in the same order below) 229, 338, 314 min/holiday, p < 0.05) and had the largest strabismus angle (mean strabismus angle at near: 30, 22, 18 PD, p < 0.01; at far: 28, 26, 21 PD, p<0.05).</p><p><strong>Conclusion: </strong>The clinical features of acquired comitant esotropia and hand-held digital device usage differed between children aged ≤ 12 years and older patients. This report gives the current clinical characteristics of young patients with acquired esotropia and digital device usage.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10571298","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":"Scientific Reviewers.","authors":"","doi":"10.1007/s10384-023-01029-z","DOIUrl":"10.1007/s10384-023-01029-z","url":null,"abstract":"","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72014149","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":"Inhibition of anterior capsule opacification and contraction by the elevated anterior rim of the intraocular lens optic.","authors":"Mayumi Nagata, Hiroyuki Matsushima, Koichiro Mukai, Tadashi Senoo, Okihiro Nishi","doi":"10.1007/s10384-023-01013-7","DOIUrl":"10.1007/s10384-023-01013-7","url":null,"abstract":"<p><strong>Purpose: </strong>To verify the anterior capsule opacification (ACO) and contraction (ACC) of the ZCB00V intraocular lens (IOL), made of the same material as the AR40e with a high ACC rate.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>We evaluated 35 patients at 1 week, 1, 3 and 6 months post phacoemulsification with either a ZCB00V (n = 35) or FY-60AD (n = 34) IOL implantation. The ACC rate was calculated using retroillumination images of the anterior segment, and the ACO was measured using anterior segment photographs and image analysis software. The contact grade between the IOL and anterior capsule was estimated from the Pentacam^® images.</p><p><strong>Results: </strong>The postoperative ACC rates (mean ± standard deviation) at 3 months were 1.03%±2.54% for the ZCB00V and, and 7.12%±9.47% for the FY-60AD. The ZCB00V-implanted eyes showed a significantly lower postoperative ACC at 1 week, 3 months, and 6 months (P < 0.01). On the other hand, the FY-60AD-implanted eyes had more pronounced ACO, and a significantly larger area of opacification (62.24%±21.32% vs. 16.90%±8.34%; P = 0.0005). Pentacam^® analysis revealed a space between the anterior capsule and IOL surface in the ZCB00V-implanted eyes, whereas the anterior capsule firmly adhered to the IOL surface in the FY-60AD-implanted eyes.</p><p><strong>Conclusion: </strong>The ACC and ACO were significantly lower in eyes with ZCB00V IOLs compared to those with the FY-60AD. The anterior segment image analysis revealed that the elevated anterior rim of the ZCB00V IOL prevented adhesion between the anterior capsule and IOL optic surface, suggesting an open capsule effect.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10284681","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}