Journal of analytical toxicology最新文献

{"title":"Pregabalin concentrations: establishing 'normal' and 'cause for concern' concentration ranges in postmortem blood.","authors":"Limon Khatun Nahar, Sue Paterson","doi":"10.1093/jat/bkaf005","DOIUrl":"10.1093/jat/bkaf005","url":null,"abstract":"<p><p>Pregabalin (PGL) is prescribed for the treatment of neuropathic pain, epilepsy, and general anxiety disorder; however, studies have shown that PGL is being misused. It is generally accepted that those who misuse PGL use it in amounts significantly greater than the recommended therapeutic dose. In some instances, such high doses may be well tolerated, and in some instances, the same dose may cause death. Individual variation and postmortem (PM) changes make it extremely challenging for toxicologists to determine if a drug concentration found at PM was contributory to death or not. Unfortunately, meaningful PM data, which can help with interpreting PGL concentrations in femoral-vein blood, are rare. Only one recommendation was found where an author suggested that a PGL concentration of >25 µg/mL in PM blood should be considered as significant; however, in this case series PGL was only screened for in specific cases. To aid interpretation of PGL concentrations, reference data from toxicological analysis conducted on femoral-vein blood only from all manners of death are needed to compile meaningful and unbiased concentration ranges. This study looked at PGL femoral-vein blood concentrations in PM cases from all manners of death over a 2-year period. As it is impossible to define a PM concentration that should be considered toxic/fatal, this study aimed to provide a concentration cut-off where the PGL may be considered a 'normal' incidental finding (unlikely to be the cause of death) or a 'cause for concern' where it may have been taken in excess and caused or contributed to death. This study recommends that a PGL concentration of ≥20 µg/mL in femoral-vein blood should be considered as significant and a 'cause for concern'. Concentrations of ≤19 µg/mL may be considered a 'normal' incidental finding in death, but tolerance and other drug findings need to be considered.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":"272-279"},"PeriodicalIF":2.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122843","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":"Brain concentrations and brain-blood ratios of amitriptyline and nortriptyline in forensic postmortem cases.","authors":"Mikayla Zoë van der Meer, Brian Schou Rasmussen, Michael Nedahl, Marie Katrine Klose Nielsen","doi":"10.1093/jat/bkaf017","DOIUrl":"10.1093/jat/bkaf017","url":null,"abstract":"<p><p>Concentrations of amitriptyline and nortriptyline in postmortem blood samples may not accurately reflect the concentrations at the time of death due to postmortem redistribution or degradation. The brain is suggested as an alternative matrix since it is less subjected to postmortem redistribution and more protected against trauma and putrefaction, but reference concentrations in brain tissue are scarce. In this study, we aimed to provide concentrations in brain tissue and brain-blood ratios in 53 postmortem cases, where amitriptyline and/or nortriptyline were detected. To establish reference levels, each case was assigned to one of three classes according to the cause of death: (i) lethal intoxication by the sum of amitriptyline and nortriptyline or nortriptyline alone, (ii) lethal intoxication by the drugs in combination with other drugs, and (iii) the cause of death was not influenced by amitriptyline and/or nortriptyline. A positive correlation between blood and brain concentrations was found with a Spearman coefficient of 0.98. In 42 cases, where both drugs were detected, the 10-90 percentiles in brain tissue ranged from 0.17-9.1 mg/kg (median: 0.78 mg/kg) for amitriptyline and 0.22-5.0 mg/kg (median: 1.43 mg/kg) for nortriptyline across all classes. In 11 cases where only nortriptyline was detected, the percentiles ranged from 0.32-7.2 mg/kg (median: 0.28 mg/kg) in brain tissue. A median brain-blood ratio of 3.4 was found for amitriptyline, 8.5 for nortriptyline as a metabolite of amitriptyline and 9.7 for nortriptyline as an individual ingested drug. No significant difference was found between the different classes. The obtained brain concentrations and brain-blood ratio can contribute to the alternative or complementary use of brain tissue for future toxicological investigations.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":"209-215"},"PeriodicalIF":2.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A fully validated LC-QTOF-MS screening workflow for the analysis of drugs in oral fluid.","authors":"Cynthia Coulter, Jonah Gonzales, Campbell A Coulter, Jarrad Wagner, Christine Moore","doi":"10.1093/jat/bkaf013","DOIUrl":"10.1093/jat/bkaf013","url":null,"abstract":"<p><p>A simple liquid-liquid extraction procedure followed by liquid chromatography-quadrupole time of flight tandem mass spectrometry (LC-QTOF-MS) analysis for drugs in oral fluid collected with the Quantisal™ device has been developed. The decision point cut-off concentrations were at or below those recommended by the National Safety Council's Alcohol, Drugs, and Impairment Division (NSC-ADID) for toxicological investigation of driving under the influence of drugs cases. Currently, the American Acadamy of Forensic Sciences and the Academy Standards Board (ANSI/ASB) Standard 120 does not cover the analysis of oral fluid collected in impaired driving investigations; instead guidance from the NSC-ADID was used. The supporting mass spectral-based screening library was adapted from commercially available databases and included Tier 1 and Tier 2 recommended compounds. Further, the additional inclusion of novel psychoactive substances and synthetic cannabinoids was based on the Center for Forensic Science Research and Education's quarterly publications of 2023. Metabolites from those publications were not included in this method since, with some exceptions, parent drugs are the dominant compounds in oral fluid. Briefly, Quantisal™ (1 mL) was mixed with organic solvents, centrifuged, and decanted; followed by a second liquid-liquid process which extracted all the drugs in a single aliquot. A gradient liquid chromatography program using 0.1% formic acid in water and 0.1% formic acid in methanol was used and the runtime was 10 minutes. LC-QTOF-MS settings were optimized to promote greater sensitivity for a wide range of drug classes. The method was fully validated using ANSI/ASB 036 Standard Practices for Method Validation in Forensic Toxicology as guidance. Interference studies, limit of detection, precision at and around the decision points, ionization suppression/enhancement, and processed sample stability up to 96 hours were completed for each drug in the library database. While ion suppression or enhancement of the analytes varied greatly, the decision point was not significantly affected and internal standards that mimicked similar responses were chosen for each analyte. The method was applied to proficiency program samples, routine samples received in the laboratory, and blind samples screened against the search engine. The optimization of specific tune characteristics and instrument settings allowed the user to meet or exceed recommended screening limits for drugs in Quantisal™ collected oral fluid samples without the need for immunoassay testing.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":"265-271"},"PeriodicalIF":2.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441039","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":"Retrospective fentanyl analysis in the hair of workplace drug testing subjects.","authors":"G Neil Stowe, Ryan B Paulsen, Michael I Schaffer","doi":"10.1093/jat/bkaf010","DOIUrl":"10.1093/jat/bkaf010","url":null,"abstract":"<p><p>The powerful opioid analgesic fentanyl has become readily available in the most recent phase of the ongoing opioid crisis. While fentanyl does have important medicinal uses, it is highly prone to misuse and nonmedical use. In addition, the relative ease of fentanyl synthesis lends it subject to structural modifications by clandestine chemists to produce fentanyl analogs (often termed fentalogs) that are designed to evade detection by law enforcement and forensic toxicologists. Herein, we report fentanyl data as measured by liquid chromatography-tandem mass spectrometry (LC-MS-MS) with extensively washed hair as the matrix in the USA workforce population over the years 2019-24. The limit of detection and limit of quantitation for our method was set at 1.0 pg analyte/mg hair. From our data, we find that ∼94% of samples with concentrations >150 pg fentanyl/mg hair contained measurable norfentanyl metabolite above 1.0 pg/mg hair. In our studied population, only one sample containing the presence of a fentanyl analog was observed in the absence of fentanyl itself. It thus appears that fentanyl analogs are most often found in combination with, or as contaminants of, fentanyl consumed by our study population.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":"258-264"},"PeriodicalIF":2.3,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425378","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":"Evaluation of DrugWipe® 6S with the WipeAlyser® reader for drug screening of drivers.","authors":"Ragnhild Elén Gjulem Jamt, Hallvard Gjerde, Grethe Brennhovd Clausen, Lihn Bache-Andreassen, Elisabeth Leere Øiestad","doi":"10.1093/jat/bkaf028","DOIUrl":"https://doi.org/10.1093/jat/bkaf028","url":null,"abstract":"<p><p>On-site drug screening of oral fluid samples has gained attention because of its convenience and rapid results. The aim of this investigation was to compare the results of preliminary screening for drugs in oral fluid samples collected from suspected drug-impaired drivers using DrugWipe 6S and WipeAlyser reader with the results obtained from blood samples. Additionally, we compared the DrugWipe test results with findings of drug traces detected within the used DrugWipe devices. Police officers selected a sample of 355 suspected drug-impaired drivers in 2023. They used DrugWipe 6S for preliminary drug screening of drivers. After the field drug testing of oral fluid, the apprehended drivers were brought to a physician for the collection of blood samples. The collected samples (DrugWipe devices and blood samples) were submitted to the Norwegian National Forensic Toxicology Laboratory for analysis. The proportion of positive DrugWipe results that were unconfirmed when analysing blood samples was 82% for opiates, 75% for cocaine, and ∼19%-20% for amphetamines, cannabis, and benzodiazepines. The proportion of negative DrugWipe results that were found positive in blood samples was for cannabis and benzodiazepines ∼13%-14%, and for other drugs <3%. Detected drug traces in the used DrugWipe devices corresponded well with DrugWipe readouts for cannabis, amphetamines, and cocaine. The lack of correspondence between DrugWipe test results for cocaine and findings in blood may be due to the fact that the concentration of cocaine in saliva is often much higher than in blood, and the DrugWipe test is very sensitive. In addition, degradation and elimination of cocaine before the blood sample is taken may contribute to cocaine concentrations below the cut-off concentration in blood. For opiates and benzodiazepines, traces of drugs were found in relatively few DrugWipe devices. Many unconfirmed positives for opiates were most likely due to cross-reaction with substances in 'snus' (snuff tobacco).</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984715","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":"Synthetic cannabinoids receptor agonists in oral fluid: development of a dispersive liquid-liquid microextraction (DLLME) method with liquid chromatography-mass spectrometry detection.","authors":"Henrique Silva Bombana, Gabriela de Paula Meirelles, Rodrigo Alves de Oliveira, Vilma Leyton, Mauricio Yonamine","doi":"10.1093/jat/bkaf027","DOIUrl":"https://doi.org/10.1093/jat/bkaf027","url":null,"abstract":"<p><p>Synthetic cannabinoid receptor agonists (SCRAs) comprise a class of new psychoactive substances (NPS) that rank second in terms of notified substances to the United Nations Office on Drugs and Crime. Moreover, SCRAs are the most prevalent NPS in Brazilian territory. Given the risks they pose to public health, there is a pressing need to develop simple and rapid sample preparation methods in alternative biological matrices that are easy to handle and collect, such as oral fluid (OF). In this study, dispersive liquid-liquid microextraction (DLLME) was employed to determine twelve SCRAs in OF. For 200 µL of sample (mixture of OF and Quantisal™ buffer), 200 µL of ice-cold acetonitrile were used as the dispersive solvent, and 100 µL of ethyl acetate were used as the extraction solvent. The limits of detection ranged from 0.5 to 2 ng/mL, while the limits of quantification were 2 ng/mL for ADB-FUBIATA and 1 ng/mL for the other analytes. The working range was 1-100 ng/mL, except for ADB-FUBIATA, which had a range of 2-100 ng/mL. The coefficients of variation for quantified analytes were <11.3% for within-run precision, <12.6% for between-run precision, and <15.8% for accuracy across all controls. The developed method was applied to six suspected samples, and one sample yielded a positive result with 39.9 ng/mL of MDMB-4en-PINACA, the most prevalent SCRA in São Paulo State, Brazil.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772359","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":"Beyond the baseline: quantification of two phosphatidylethanol homologues in whole blood by LC-MS-MS and retrospective data analysis from a National Reference Laboratory.","authors":"Nicole J Mathewson, Nkemakonam C Okoye, Heather A Nelson, Vrajesh Pandya, Chad Moore, Kamisha L Johnson-Davis","doi":"10.1093/jat/bkae100","DOIUrl":"10.1093/jat/bkae100","url":null,"abstract":"<p><p>Alcohol is the most abused substance in Western society, resulting in major economic losses and negative health consequences. Therefore, there is a need for a selective and robust detection method for alcohol consumption in various clinical and forensic settings. This study aimed to validate a mass spectrometry method for quantifying phosphatidylethanol (PEth) and perform retrospective data analysis from the patient population of a national reference laboratory. Quantification of PEth in whole blood was accomplished using an LC-MS-MS assay. Isotopically labeled internal standard for the two PEth homologues was added to the whole-blood specimen, followed by protein precipitation with a mixture of acetonitrile and isopropyl alcohol. After centrifugation, an aliquot of the supernatant was buffered with ammonium acetate before LC-MS-MS analysis on an Agilent 6470 triple quadrupole mass spectrometer coupled to an Agilent 1260 Infinity II LC system. This LC-MS-MS assay was validated for clinical use in accordance with Clinical & Laboratory Standards Institute guidelines. The analytical measurement range, 10-2000 ng/mL, was linear with R2 of 0.999. The within-run and total imprecision was < 5% CV for the low (20 ng/mL), medium (200 ng/mL), and high QC (1000 ng/mL). Results from accuracy and method comparison experiments met the bias criteria of ±15%. Retrospective data analysis showed ∼27% of patients had PEth concentrations <20 ng/mL. Males and females had similar positivity rates for PEth and the positivity rate of women of reproductive age (15-44 years old) was 35% in comparison to 25% in women 45-89 years old. This study's LC-MS-MS method showed acceptable analytical performance in quantifying PEth as a sensitive and specific biomarker for evaluating alcohol consumption. Results from this study may provide an opportunity to educate women of reproductive age on drinking during pregnancy and the long-term effects of alcohol use.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":"191-200"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of dichloromethane, nitrate, and sulfhemoglobin-induced substances on carboxyhemoglobin detection: a comprehensive review.","authors":"Jialin Wu, Yujing Luan, Qingxia Zhang, Fanglin Wang, Yulan Rao","doi":"10.1093/jat/bkae096","DOIUrl":"10.1093/jat/bkae096","url":null,"abstract":"<p><p>Carbon monoxide (CO) is a common gaseous toxin that causes severe poisoning symptoms. Accurate detection of the formation of carboxyhemoglobin (COHb) in the blood is very important for the identification of CO poisoning. In this review, the effects of exogenous toxins, including dichloromethane (DCM), nitrite, and hydrogen sulfide, on the determination of COHb by spectrophotometry are summarized by comparing epidemiological data, case studies, and analytical methods. The mechanism of the effects of these exogenous poisons on COHb detection is described, and the extent of their influence on the clinical diagnosis and forensic identification of CO poisoning is discussed. We suggest that emergency medicine and forensic science practices need to improve the understanding of these toxins and optimize clinical diagnosis and evaluation strategies to address the effects of toxins on the determination of COHb.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":"170-179"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836506","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":"Bladder wash: a proof of concept as an alternative specimen for postmortem toxicology.","authors":"Luke N Rodda, Kylie E Candela, Amy P Hart, Ellen G Moffatt, Megan C Farley, Sue Pearring, Karen S Scott","doi":"10.1093/jat/bkaf001","DOIUrl":"10.1093/jat/bkaf001","url":null,"abstract":"<p><p>In postmortem forensic investigation cases where the bladder is voided or dehydrated prior to autopsy, it is possible to wash the bladder with saline to collect the \"bladder wash\" and any residual urine for toxicological analysis. While not conventional, this study aims to determine the use of bladder washes as alternative specimens in postmortem forensic toxicology. Comprehensive drug and alcohol analysis was performed on blood, urine, vitreous humor, and bladder wash samples. Control studies consisted of matched bladder wash and urine samples for comparison. Authentic applicability studies were performed on bladder wash samples in cases where only blood or no urine samples were available. Bladder wash testing via the routine urine methodology was shown to have the appropriate sensitivity and specificity to serve as an alternative specimen. Specificity of the applicability studies was further improved when comparisons were corrected by evaluating individual analytes jointly with their related parent drug or metabolites. Individual and corrected sensitivity and specificity rates of above 99% were typically observed in both comparisons against urine and blood paired samples. Following drug analysis of 31 cases in which only a bladder wash was available, 57 detections from 23 different analytes were detected that otherwise would not have been obtained. This study demonstrates that standardized collection of the easily accessible bladder wash for postmortem toxicological analysis serves forensic toxicologists and pathologists with invaluable information where urine or other biological specimens are not available.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":"180-190"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970663","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":"Advances in analytical methodologies for detecting novel psychoactive substances: a review.","authors":"Alex J Krotulski, Dani C Mata, Christina R Smith, Kaitlyn B Palmquist-Orlando, Celia Modell, Svante Vikingsson, Michael T Truver","doi":"10.1093/jat/bkae098","DOIUrl":"10.1093/jat/bkae098","url":null,"abstract":"<p><p>Novel psychoactive substances (NPSs) have historically been difficult compounds to analyze in forensic toxicology. The identification, detection, and quantitation of these analytes and their metabolites have been difficult due to their rapid emergence, short lifespan, and various potencies. Advancements in analytical instrumentation are fundamental to mitigating these NPS challenges by providing reliable identification and sensitivity. This review discusses the pros and cons of various analytical instruments that have played a pivotal role in NPS analysis. As analytical technology advanced, the ability to analyze for NPS became easier with high-resolution mass spectrometry (MS); however, traditional immunoassays are still beneficial for some NPS classes such as benzodiazepines. Over 200 articles from 2010-23 were reviewed, and 180 were utilized for this review. Journal articles were categorized according to the technology used during analysis: immunoassay, gas chromatography-MS, liquid chromatography-MS-low resolution, and liquid chromatography-MS-high resolution to allow for quick references based on a laboratory's technologies. Journal articles were organized in table format to outline the authors, NPS drug classes, and instrumentation used, among other important information.</p>","PeriodicalId":14905,"journal":{"name":"Journal of analytical toxicology","volume":" ","pages":"152-169"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949241","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}