{"title":"Surveillance of SARS-CoV-2 Infection in Rodent Populations in Tokyo, Japan.","authors":"Yudai Kuroda, Akitoyo Hotta, Masakatsu Taira, Nobuo Koizumi, Kango Tatemoto, Eun-Sil Park, Milagros Virhuez-Mendoza, Tsukasa Yamamoto, Noriyuki Komatsu, Keigo Shibo, Takeshi Sasaki, Yoshiyuki Mori, Kentaro Watanabe, Yasushi Kiyokawa, Yuya Eguchi, Azusa Banzai, Hirotaka Katahira, Tsutomu Tanikawa, Ken Maeda","doi":"10.7883/yoken.JJID.2024.143","DOIUrl":"10.7883/yoken.JJID.2024.143","url":null,"abstract":"<p><p>The persistence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among wildlife populations poses a potential risk for the emergence of novel variants. Therefore, monitoring SARS-CoV-2 infections in animals is crucial. As urban rodents live in close proximity to human habitats, there is a concern that they may be a potential source of zoonoses. To examine the prevalence of SARS-CoV-2 in rodent populations, we analyzed 128 serum samples and 129 oral swabs collected from 128 brown rats (Rattus norvegicus) and two black rats (Rattus rattus) captured for pest control purposes in Tokyo, Japan, between May and December 2023. A virus-neutralizing test using the omicron variant revealed no evidence of SARS-CoV-2 infection. Real-time reverse transcription- PCR of oral swabs did not detect any SARS-CoV-2 RNA-positive rats. These results indicate a low probability of SARS-CoV-2 circulation among rat populations in Tokyo.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":"342-344"},"PeriodicalIF":1.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859790","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}
Jie Chen, Pengfei You, Xiaoyan Chen, Huafeng Li, Na Zhang, Guangyun Zhang, Conghong Xu, Chunling Ma, Yanli Zhang, Tiegang Lv
{"title":"Genetic Characteristics and Phylogenetic Analysis of Coxsackievirus A6 Isolated in Linyi, China, 2022-2023.","authors":"Jie Chen, Pengfei You, Xiaoyan Chen, Huafeng Li, Na Zhang, Guangyun Zhang, Conghong Xu, Chunling Ma, Yanli Zhang, Tiegang Lv","doi":"10.7883/yoken.JJID.2024.072","DOIUrl":"10.7883/yoken.JJID.2024.072","url":null,"abstract":"<p><p>Hand, foot, and mouth disease (HFMD) has become one of the most common infectious diseases in the past few decades. Since 2013, coxsackievirus A6 (CVA6) has replaced enterovirus A71 (EV-A71) and coxsackievirus A16 (CVA16), becoming the predominant pathogen responsible for HFMD in many areas of China. This study aimed to investigate the genetic characteristics and molecular epidemiology of CVA6 in Linyi between the years 2022 and 2023. In total, 965 patients with HFMD were enrolled in this study, and analyses based on VP1 nucleotide sequences were performed to determine the evolutionary trajectory of CVA6. In 2022, 281/386 (72.8%) patients were positive for enteroviruses (EVs) and 217/281 (77.2%) were CVA6 positive. In 2023, 398/579 (68.7%) samples were positive for EVs and 243/398 (61.1%) were CVA6 positive. Six sequences were selected each year for homology analysis. The results showed that the 12 strains isolated from Linyi were distant from the prototype strain (AY421764) and the first CVA6 strain reported in China (JQ364886). Phylogenetic analysis showed that the CVA6 strains isolated from Linyi belonged to the D3 sub-genotype. CVA6 is emerging as a common pathogen causing HFMD in Linyi and continuous surveillance of HFMD etiologies agents is necessary.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":"311-316"},"PeriodicalIF":1.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467921","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":"Distribution and Antimicrobial Susceptibility Pattern of CTX-M-type Extended-Spectrum β-Lactamase-Producing Escherichia coli Isolated in Chubu Region, Japan.","authors":"Kazuya Itadani, Yoshimi Oonishi, Harumi Hisada, Tomoaki Tanaka, Shingo Mizunaga, Yuka Yamagishi, Hiroshige Mikamo","doi":"10.7883/yoken.JJID.2024.079","DOIUrl":"10.7883/yoken.JJID.2024.079","url":null,"abstract":"<p><p>The widespread prevalence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli limits treatment options and is a worldwide problem. This study aimed to investigate the antimicrobial susceptibility and ESBL types of 204 strains of CTX-M-type ESBLsproducing E. coli isolated from 2011 to 2017 in the Chubu region of Japan and to identify factors correlated with susceptibility. Minimal inhibitory concentrations were determined in accordance with the guidelines of the Clinical and Laboratory Standards Institute. Genes encoding β-lactamases were detected by PCR amplification. The CTX-M subtypes were determined using sequence analyses. CTX- M-15-producing strains showed significantly lower susceptibility rates to tazobactam/piperacillin (TAZ/ PIPC) than CTX-M-14 and -27-producing strains. Additional analyses of secondary β-lactamases revealed that most of the OXA-1-positive strains were CTX-M-15-producing strains (94.7%). The OXA-1-positive strains displayed significantly lower susceptibility to TAZ/PIPC (47.4%), sulbactam/ ampicillin (0.0%), and amikacin (73.7%) than the OXA-1-negative strains, suggesting that the high non-susceptibility rate of the CTX-M-15-producing strain was due to the co-carriage of OXA-1. Statistical analyses showed that OXA-1-positive strains were present in significant amounts in patients aged ≥65 years, suggesting that older patients have a higher risk of being refractory to treatment.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":"334-341"},"PeriodicalIF":1.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467920","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":"A Case of Food Poisoning Caused by Campylobacter jejuni after the Ingestion of Undercooked Chicken Meal with Subsequent Development of Guillain-Barré Syndrome.","authors":"Satoru Akase, Hiromi Obata, Wakaba Okada, Dai Saiki, Noriko Konishi, Keiko Yokoyama, Kenji Sadamasu","doi":"10.7883/yoken.JJID.2024.108","DOIUrl":"10.7883/yoken.JJID.2024.108","url":null,"abstract":"<p><p>Campylobacter jejuni is one of the major bacterial strains that cause diarrhea in humans. It has been associated with many cases of food poisoning in Japan caused by eating raw, undercooked, and/or improperly prepared chicken meat, liver, and grilled chicken (Yakitori). Campylobacter jejuni is also known to be a preceding infectious pathogen of Guillain-Barré syndrome (GBS), which has a considerably negative health impact on humans. In a case of C. jejuni food poisoning that occurred at a restaurant in Tokyo (Japan) in January 2022, 1 of 4 patients with diarrhea developed GBS, which was presumed to have been caused by undercooked chicken, which has emerged as one of the most common causes of food poisoning in Japan. Moreover, C. jejuni isolates from 3 patients, including those with GBS, had the same genotypes (ST22, HS19, and LOS A). This genotype was frequently detected in patients with GBS in the authors' previous study. Findings confirmed that the patient developed GBS due to food poisoning after consuming undercooked chicken.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":"353-355"},"PeriodicalIF":1.3,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467917","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}
Mei Shi, Chun-Yu Zhang, Dan-Yang Zou, Juan Wu, Nan-Hui Wu, Li-Yan Ni, Zhi-Fang Guan, Qian Du, Rui-Rui Peng, Fu-Quan Long
{"title":"Immunohistochemical Analyses of Monkeypox Skin Lesions with MPXV A29 and A35 Antibodies: A Novel Insight for Clinical-Histopathological Forms.","authors":"Mei Shi, Chun-Yu Zhang, Dan-Yang Zou, Juan Wu, Nan-Hui Wu, Li-Yan Ni, Zhi-Fang Guan, Qian Du, Rui-Rui Peng, Fu-Quan Long","doi":"10.7883/yoken.JJID.2024.145","DOIUrl":"https://doi.org/10.7883/yoken.JJID.2024.145","url":null,"abstract":"<p><p>The aim of this study was to describe the clinical, histopathological, and immunohistochemical characteristics of MPX and offer meaningful insights into the clinicopathology of MPX. We recruited eight men who had sex with men diagnosed with MPX based on positive results from MPX Virus (MPXV)-specific polymerase chain reaction. Skin biopsies were obtained from four selected lesions, including typical and atypical lesions. Histopathological examinations of atypical solitary ulceration revealed infiltrating inflammatory cells predominantly composed of plasma cells and lymphocytes, forming a \"sleeve\" around the superficial vessels of the dermis. These features might be misinterpreted as indicative of cutaneous syphilis infection. Meanwhile, typical pustular lesions displayed central necrotic epidermis accompanied by perivascular inflammatory infiltrate dominated by neutrophils, as well as ballooning and reticular degeneration of keratinocytes. Additionally, multinucleated keratinocytes and eosinophilic cytoplasmic inclusions known as Guarnieri's bodies were also observed. Importantly, this study represented the pioneering report on immunohistochemical detection of MPXV A29 and A35 proteins in skin lesions, distinguishing it from previous studies that focused on detecting vaccinia virus protein. The anti-MPXV A29 antibody exhibited robust cytoplasmic staining specifically within affected keratinocytes in both adjacent epidermis and hair follicles, thereby it could contribute to the diagnosis of MPX, especially for cases with atypical skin lesions.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545485","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}
Samia Alaoui Boukhris, Mounia El Khadir, Safae Karim, Tiatou Souho, Dafr-Allah Benajah, Sidi Adil Ibrahimi, Laila Chbani, Mohamed El Abkari, Bahia Bennani
{"title":"Gastric cancer and associated pathogens: is there any association in Moroccan region?","authors":"Samia Alaoui Boukhris, Mounia El Khadir, Safae Karim, Tiatou Souho, Dafr-Allah Benajah, Sidi Adil Ibrahimi, Laila Chbani, Mohamed El Abkari, Bahia Bennani","doi":"10.7883/yoken.JJID.2024.147","DOIUrl":"https://doi.org/10.7883/yoken.JJID.2024.147","url":null,"abstract":"<p><p>Helicobacter pylori, Epstein-Barr virus and human papillomavirus are three pathogens associated with various human cancers. This study aimed to investigate the role of these pathogens in gastric cancer in Moroccan population. For this, a retrospective study has been conducted on participants attending the gastroenterology department of Hassan II University Hospital of Fez. A total of 279 participants were enrolled. H. pylori, EBV and HPV were detected and genotyped by PCR. In results, a significant association has been established between H. pylori, EBV and gastric cancer. 93.4% and 43.3% of gastric cancer cases are related to H. pylori and EBV respectively (p≤0.01). H. pylori-EBV co-infection is responsible of 31.6% of gastric cancer cases (p<0.01). Correlation between pathogens genotypes and gastric cancer shows 54.6% of GC EBV positives are carrying the 30 bp deletion in LMP1gene, while 16% of gastric cancers cases are carrying high-risk genotypes of HPV (p=0.21). The obtained results highlight the possible role of co-infection in gastric cancer development.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545484","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":"Clinical Characteristics and Risk Factors for Severe Japanese Spotted Fever: A Retrospective Multicenter Study in Nagasaki Prefecture, Western Japan.","authors":"Kohsuke Matsui, Shingo Masuda, Yosuke Koizumi, Monami Yamanaka, Yasumori Izumi, Chris Smith, Reiko Miyahara, Koya Ariyoshi","doi":"10.7883/yoken.JJID.2024.216","DOIUrl":"https://doi.org/10.7883/yoken.JJID.2024.216","url":null,"abstract":"<p><p>Japanese spotted fever (JSF) is a tick-borne rickettsial disease prevalent in western Japan, with an increasing incidence and geographical distribution. This retrospective study aimed to describe the clinical features of JSF and identify factors associated with its severe form. We included adult patients with laboratory confirmed JSF in Nagasaki prefecture from 2010 to 2021. Severe JSF was defined by the presence of altered mental status, low blood pressure, or low oxygen saturation. In total, 65 JSF cases were diagnosed. Common symptoms were fever (87%), rash (48%), and fatigue (48%) with eschars detected in 50 (79.4%) of patients. Thirty-eight (60.3%) patients were initially diagnosed with non-JSF conditions. Twenty-one (33.3%) cases were categorized as severe JSF, including one death. Pre-hospital factors associated with severe JSF included age ≥75 (adjusted odds ratio [aOR] 37.53, 95% confidence interval [CI] 3.03-465.38), male sex (aOR 26.5, 95% CI 4.23-166.00), and a treatment delay ≥4 days from onset (aOR 5.96, 95% CI 1.13-31.60). This study highlights diagnostic challenges of JSF due to its non-organ-specific clinical presentation. Delayed initial treatment, advanced age, and male sex significantly increase the risk of severity. It is crucial to further raise awareness of JSF among clinicians and residents in endemic areas.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545483","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":"Clinical Efficacy of Therapeutic Agents for Clostridioides difficile Infection Based on Four Severity Classifications.","authors":"Mariko Ohtani, Sadako Yoshizawa, Taito Miyazaki, Eri Kumade, Shinobu Hirayama, Maki Sakamoto, Hinako Murakami, Tadashi Maeda, Yoshikazu Ishii, Takahiro Matsumoto, Kazuhiro Tateda","doi":"10.7883/yoken.JJID.2023.483","DOIUrl":"10.7883/yoken.JJID.2023.483","url":null,"abstract":"<p><p>Japanese guidelines recommend metronidazole (MNZ) and vancomycin (VCM) for non-severe and severe cases of Clostridioides difficile infection (CDI), respectively. In the present study, we investigated the use of CDI antimicrobials and evaluated their clinical efficacy and validity using four severity classifications. A retrospective chart review was conducted using the data of 137 inpatients with initially positive C. difficile toxin test results and the initiation of CDI antimicrobials between April 2015 and March 2019. Patients treated with VCM or oral MNZ were included for clinical efficacy analysis of CDI antimicrobials and validation of severity classifications. The endpoints were CDI recurrence, 30-day mortality, and diarrhea cure rates. No significant differences were found between the VCM and oral MNZ groups in the CDI recurrence rate (10.4% vs. 12.7%, P = 0.707), 30-day mortality rate (12.5% vs. 5.6%, P = 0.162), and diarrhea cure rate (61.9% vs. 72.7%, P = 0.238), regardless of severity. Treatment with oral MNZ for non-severe cases was promising, confirming its usefulness according to Japanese guidelines. Further investigation of the clinical efficacy of oral MNZ in patients with first-episode CDI and evaluation of the preferred severity classification are warranted.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":"281-284"},"PeriodicalIF":1.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140331714","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}
Jie Zheng, Qiu-Jin Yang, Fei Qi, Han-Zhang Shen, Le Zhang, Jia-Wei Xia
{"title":"Continuous Renal Replacement Therapy Improves Indicators and Short-Term Survival in People with AIDS Manifesting Sepsis and Acute Kidney Injury.","authors":"Jie Zheng, Qiu-Jin Yang, Fei Qi, Han-Zhang Shen, Le Zhang, Jia-Wei Xia","doi":"10.7883/yoken.JJID.2023.280","DOIUrl":"10.7883/yoken.JJID.2023.280","url":null,"abstract":"<p><p>Patients with acquired immune deficiency syndrome (AIDS) are susceptible to numerous complications, such as sepsis and acute kidney injury (AKI), leading to adverse outcomes. Continuous renal replacement therapy (CRRT) is becoming increasingly popular for treating sepsis and AKI. This study aimed to verify the effectiveness of CRRT in the treatment of patients with AIDS with sepsis and AKI to provide new directions for the treatment of severe AIDS. Data of 74 people with AIDS, sepsis, and AKI were collected. The patients were divided into CRRT and non-CRRT groups. There was no difference in the indicators between the two groups at admission. Vital signs, pH, serum potassium level, renal function, blood lactate level, acute physiology and chronic health evaluation II score, and sequential organ failure assessment score in the CRRT group demonstrated significant improvements over those in the non-CRRT group at both 24 and 72 h after admission (P < 0.05). The levels of interleukin 6 and procalcitonin declined more significantly in the CRRT group at 72 h after admission (P < 0.05). The CRRT group had a higher 28-day survival rate than the non-CRRT group (P < 0.05). CRRT improves the clinical indicators and increases the short-term survival rate of patients with AIDS, sepsis, and AKI.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":"240-243"},"PeriodicalIF":1.3,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139990066","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":"Clinical Course and Molecular Characterization of Human Bocavirus Associated with Acute Lower Respiratory Tract Infections in a Tertiary Care Hospital in Northern India.","authors":"Subhabrata Sarkar, Mannat Kang, Suresh Kumar Angurana, Shankar Prasad, Ishani Bora, Pankaj Singh, Vikrant Sharma, Meenakshi Rana, Bhartendu Singh, Muralidharan Jayashree, Radha Kanta Ratho","doi":"10.7883/yoken.JJID.2023.251","DOIUrl":"10.7883/yoken.JJID.2023.251","url":null,"abstract":"<p><p>Respiratory samples from 139 hospitalized children were screened for the human bocavirus (HBoV) genome. Positive samples were sequenced for the partial VP1/VP2 gene followed by molecular and phylogenetic analyses. HBoV positivity was noted in 7.2% (10/139) of patients. All HBoV-positive children presented with fever, cough, and respiratory distress (90%, 9/10). Three children developed multisystemic viral illness, with one fatality. Eight children required intensive care management and five required mechanical ventilation. The nucleotide percent identity of the partial VP1/VP2 gene in the HBoV study strains ranged from 97.52% to 99.67%. Non-synonymous mutations in the VP1 protein were T591S (n = 8) and Y517S (n = 1) in the HBoV St1 strain and N475S (n = 8) and S591T (n = 2) in the HBoV St2 strain. One strain showed A556P, H556P, I561S, and M562R non-synonymous mutations. All the study strains belonged to the HBoV1 type. Seven HBoV strains belonged to the same lineage, and three belonged to another lineage. For evolutionary dynamics, GTR+I substitution model with uncorrelated relaxed lognormal clock and Bayesian Skyline tree prior showed 9.0 × 10<sup>-4</sup> (95% highest probability density interval: 3.1 × 10<sup>-6</sup>, 2.1 × 10<sup>-</sup>3) nucleotide substitutions per site per year. Clinical suspicion and virological screening are necessary to identify HBoV infections in children.</p>","PeriodicalId":14608,"journal":{"name":"Japanese journal of infectious diseases","volume":" ","pages":"227-235"},"PeriodicalIF":1.3,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139990065","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}