Journal of Cardiovascular Development and Disease最新文献

{"title":"Role of Computed Tomography and Other Non-Invasive and Invasive Imaging Modalities in Cardiac Allograft Vasculopathy.","authors":"Siddhant Passey, Jagriti Jha, Nirav Patel, Vincent Lipari, Saurabh Joshi, Raymond McKay, Joseph Radojevic, Joseph Ingrassia","doi":"10.3390/jcdd12070249","DOIUrl":"https://doi.org/10.3390/jcdd12070249","url":null,"abstract":"<p><p>Cardiac allograft vasculopathy (CAV) is a leading cause of allograft dysfunction and failure. CAV prevention, early detection, and management are essential to increasing allograft survival. In this comprehensive review, we discuss various invasive and non-invasive modalities that are being utilized for CAV detection. Invasive coronary angiography provides a visualization of vascular anatomy but is limited in detecting the microvasculature and diffuse and early structural changes. The addition of intracoronary assessment techniques, including intravascular ultrasound, optical coherence tomography, and coronary flow reserve assessment, offer(s) superior sensitivity in identifying CAV. Non-invasive imaging modalities, such as cardiac magnetic resonance imaging, computed tomography angiography, and positron emission tomography, provide complementary insights into CAV with myocardial perfusion and allograft function while reducing procedural risks. Our aim is to guide clinicians in selecting appropriate imaging strategies tailored to individual recipients, to improve detection, monitoring, and outcomes in CAV.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707617","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":"Obesity Report: Distribution and Pattern by Age and Sex in Heart Failure Cohort over 10 Years in Korea.","authors":"Joongmin Kim, Geunhee Park, Haeyong Pak, Hyeongsoo Kim, Ji-Yong Jang, Hancheol Lee, Jong-Kwan Park, Seung-Jin Oh, Se-Jung Yoon","doi":"10.3390/jcdd12070244","DOIUrl":"https://doi.org/10.3390/jcdd12070244","url":null,"abstract":"<p><p>Obesity has been shown to be an independent risk factor for the development of heart failure (HF) and atherosclerotic cardiovascular disease. Here, we tried to analyze the distribution of obesity by age and sex in a 10-year sample cohort of newly diagnosed HF patients in Korea. A total of 35,869 patients newly diagnosed with HF between 2006 and 2015 from a nationally representative random sample of 1,000,000 people were included in this study. The data of age and sex for each subgroup according to body mass index were analyzed and compared with the general population. The obese group accounted for 43.3% of the total, and the frequency of obese patients was the highest among those in their 60s (4561). The proportion of obesity was the highest among those in their 40s (57.7%) and 30s (57.3%) in men and the highest among those in their 60s (52.2%) in women. The underweight group increases with age in both men and women, and the proportion of the high-aged group over 80 years old in the underweight group of women is significantly much higher than that of men. Conclusively, the proportion of obesity is higher than in the general population in HF patients. Obesity patterns analyzed by age were different for each sex.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707612","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":"The Anatomy of the Atrioventricular Node.","authors":"Robert H Anderson, Damián Sánchez-Quintana, Jorge Nevado-Medina, Diane E Spicer, Justin T Tretter, Wouter H Lamers, Zihan Hu, Andrew C Cook, Eduardo Back Sternick, Demosthenes G Katritsis","doi":"10.3390/jcdd12070245","DOIUrl":"https://doi.org/10.3390/jcdd12070245","url":null,"abstract":"<p><p>The anatomical arrangement of the atrioventricular node has been likened to a riddle wrapped up in an enigma. There are several reasons for this alleged mystery, not least the marked variability in structure between different species. Lack of detailed knowledge of the location of the node relative to the atrial and ventricular septal structures has also contributed to previous misunderstandings. Recent studies comparing the findings of gross dissection with virtual dissection of living datasets, combined with access to a large number of serially sectioned human and animal hearts, have served to provide the evidence to solve the riddle. We summarise these findings in this review. We explain how the node is located within the atrial walls of the inferior pyramidal space. It becomes the non-branching component of the atrioventricular conduction axis as the axis extends through the plane of atrioventricular insulation to enter the infero-septal recess of the left ventricular outflow tract. The node itself is formed by contributions from the tricuspid and mitral vestibules, with extensive additional inputs from the base of the atrial septum. We show how knowledge of development enhances the appreciation of the arrangements and offers an explanation as to why, on occasion, there can be persisting nodoventricular connections. We discuss the findings relative to the circuits producing atrioventricular re-entry tachycardia. We conclude by emphasising the significance of the variation of the anatomical arrangements within different mammalian species.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707622","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":"Exercise Intervention in Autonomic Function, Immunity, and Cardiovascular Health: A Precision Medicine Approach.","authors":"Jianyu Li, Junbei Bai, Guochun Liu, Ziyan Zhu, Chunmei Cao","doi":"10.3390/jcdd12070247","DOIUrl":"https://doi.org/10.3390/jcdd12070247","url":null,"abstract":"<p><p>The imbalance in the interaction between the autonomic nervous system and the immune system serves as a central mechanism in the onset and progression of cardiovascular diseases. The excessive activation of the sympathetic nervous system and suppression of vagal function contribute to chronic inflammation and cardiac remodeling. Precision medicine, by integrating multidimensional data such as genomics and metabolomics, offers a novel perspective for the personalized design of exercise interventions. This systematic review explores the bidirectional regulatory mechanisms of exercise interventions on the autonomic nervous system-immune axis and examines the potential applications of precision medicine in optimizing exercise prescriptions and clinical translation. Exercise significantly improves cardiovascular function through immunometabolic reprogramming, which includes suppressing sympathetic overactivity, enhancing vagal tone, and modulating the IL-6/IL-10 balance, as well as activating the short-chain fatty acid (SCFA)-Treg axis. Moreover, precision-medicine-driven ACE I/D gene typing provides a basis for selecting tailored exercise prescriptions, thereby significantly enhancing the efficacy of exercise interventions. By leveraging a multi-tiered \"neuro-immune-metabolic\" regulatory framework, exercise interventions contribute to improved cardiovascular health. The application of precision medicine technology overcomes individual variability constraints, advancing exercise prescription design from generalized recommendations toward personalized and dynamically adaptive strategies.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707598","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":"Iatrogenic Pneumopericardium After Pericardiocentesis: A Systematic Review and Case Report.","authors":"Andreas Merz, Hong Ran, Cheng-Ying Chiu, Henryk Dreger, Daniel Armando Morris, Matthias Schneider-Reigbert","doi":"10.3390/jcdd12070246","DOIUrl":"https://doi.org/10.3390/jcdd12070246","url":null,"abstract":"<p><strong>Background: </strong>Pneumopericardium is the presence of air within the pericardial cavity. We report a case of iatrogenic pneumopericardium following pericardiocentesis in a patient with primary cardiac angiosarcoma. Additionally, we provide a systematic review of pericardiocentesis-associated pneumopericardium to offer a comprehensive overview and evaluate the role of echocardiography in its diagnosis.</p><p><strong>Methods: </strong>The PubMed database was searched from inception until January 2025 to perform a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to evaluate articles on iatrogenic pneumopericardium following pericardiocentesis published in the English language. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports was used to appraise the included case reports.</p><p><strong>Results: </strong>Of the 108 search results obtained, after screening and a backward citation search, 37 articles were selected for inclusion in this review, accounting for a total of 37 patients. According to the JBI Critical Appraisal Checklist for Case Reports, 7 case reports were of high quality and 12 of low quality. The overall evidence of quality of the case reports was moderate, and 51.6% of patients developed hemodynamic compromise or showed signs of cardiac tamponade. The main underlying cause for the development of pneumopericardium was issues relating to the catheter drainage system; 64.9% of cases required decompressive therapy.</p><p><strong>Conclusions: </strong>Pneumopericardium can occur as a complication after pericardiocentesis and must therefore be considered in symptomatic patients. While detection by transthoracic echocardiography is difficult and relies on non-validated signs, chest X-ray and computed tomography can provide a definitive diagnosis.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707603","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":"Correction: Bhutani et al. Doxorubicin-Induced Cardiotoxicity: A Comprehensive Update. <i>J. Cardiovasc. Dev. Dis.</i> 2025, <i>12</i>, 207.","authors":"Vasvi Bhutani, Fahimeh Varzideh, Scott Wilson, Urna Kansakar, Stanislovas S Jankauskas, Gaetano Santulli","doi":"10.3390/jcdd12070242","DOIUrl":"https://doi.org/10.3390/jcdd12070242","url":null,"abstract":"<p><p>In the original publication [...].</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707590","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":"Impact of the Presence of Chronic Total Occlusions on the Survival of Patients Treated with Coronary Artery Bypass Grafting.","authors":"Albi Fagu, Joseph Kletzer, Franziska Marie Ernst, Laurin Micek, Stoyan Kondov, Maximilian Kreibich, Clarence Pingpoh, Matthias Siepe, Martin Czerny, Tim Berger","doi":"10.3390/jcdd12070243","DOIUrl":"https://doi.org/10.3390/jcdd12070243","url":null,"abstract":"<p><p>Although chronic total occlusions (CTO) are a common finding in patients treated with coronary artery bypass grafting (CABG), it is still not clear how their presence impacts the long-term outcomes achieved with surgery. We aimed to investigate the impact of CTO on the long-term results of patients with coronary artery disease who underwent CABG. Patients from 2005 to 2023 operated on at the University Hospital Freiburg-Bad Krozingen were analyzed. The primary outcome was all-cause mortality after 3-, 5-, and 10 years. The secondary outcome was the need for coronary reintervention in the follow-up period. Propensity score matching and multivariable Cox regression were performed, and Kaplan-Meier curves were used to graphically display the outcomes for the two groups. Of the 3424 patients included in the analysis, 1784 (52%) were categorized as CTO and 1640 (48%) were categorized as no-CTO. After propensity scoring, 1232 pairs were successfully matched. The 3-, 5-, and 10-year all-cause mortality was significantly higher in patients with CTO (<i>p</i> = 0.028; <i>p</i> < 0.001; <i>p</i> < 0.001). The need for coronary reintervention after 3-, 5-, and 10 years was comparable in both groups. In addition, multivariable Cox Regression showed that CTO presence (HR 1.220, 95% CI 1.047-1.420, <i>p</i> = 0.010) was an independent predictor of 10-year mortality.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707604","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":"Feasibility, Added Value, and Radiation Dose of Combined Coronary CT Angiography and Stress Dynamic CT Myocardial Perfusion Imaging in Moderate Coronary Artery Disease: A Real-World Study.","authors":"Marco Fogante, Enrico Paolini, Fatjon Cela, Paolo Esposto Pirani, Liliana Balardi, Gian Piero Perna, Nicolò Schicchi","doi":"10.3390/jcdd12070241","DOIUrl":"https://doi.org/10.3390/jcdd12070241","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to evaluate the feasibility, added value, and radiation dose of coronary computed tomography angiography (CCTA) and stress dynamic CT myocardial perfusion imaging (MPI) in patients with coronary artery disease (CAD) in a real-world setting.</p><p><strong>Materials and methods: </strong>This retrospective study included 65 patients (mean age: 51.2 ± 11.5 years; 21 female) with moderate CAD, selected from the Radiological Database of our hospital between May 2022 and December 2024. All patients underwent CCTA and stress dynamic CT-MPI using a third-generation dual-source CT scanner. The shuttle-mode acquisition technique was used for CT-MPI with 60 mL of contrast (iopamidol, 370 mg iodine/mL) administered at a flow rate of 6 mL/s. The mean myocardial blood flow (MBF) and other quantitative parameters were measured for both CAD and reference segments (RSs). A 17-segment-based analysis was employed (excluding the apex). The MBF ratio, defined as the mean MBF value of CAD segments divided by that of RS, was used with a cut-off value of 0.85 to distinguish hypoperfused from non-hypoperfused segments within CAD territories. Non-parametric statistical tests were applied.</p><p><strong>Results: </strong>A total of 1040 segments were evaluated. In 62 segments, the mean MBF of CAD territories was found to have decreased. The mean MBF and myocardial blood volume (MBV) in hypoperfused CAD segments were 65.1 ± 19.8 mL/100 mL/min and 14.5 ± 2.7 mL/100 mL, respectively, both significantly lower compared to non-hypoperfused CAD segments and RSs (<i>p</i> < 0.001). The mean effective dose of the protocol was 6.3 ± 1.4 mSv, corresponding to an estimated individual lifetime cancer risk of approximately 0.06% per test, based on BEIR VII Phase 2 modeling. This risk is cumulative, with repeat testing over a 10-year period potentially increasing lifetime cancer risk in proportion to total radiation exposure. The mean total examination time was 26 ± 4 min.</p><p><strong>Conclusion: </strong>The combined CCTA and dynamic CT-MPI protocol is feasible in real-world clinical practice and offers a comprehensive morphological and functional assessment of moderate CAD, with a manageable radiation dose and examination time.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707599","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":"Prediction of Right Heart Failure in LVAD Candidates: Current Approaches and Future Directions.","authors":"Frederick Vogel, Zachary W Sollie, Arman Kilic, Ethan Kung","doi":"10.3390/jcdd12070240","DOIUrl":"https://doi.org/10.3390/jcdd12070240","url":null,"abstract":"<p><p>Right heart failure is a condition where the right ventricle fails to pump blood into the pulmonary artery, and, in turn, the lungs. This condition frequently presents after the implantation of a left ventricular assist device (LVAD). Ventricular assist candidates who have LVADs implanted possess various pathophysiological and cardiovascular features that contribute to the later development of RHF. With LVADs serving as bridge-to-transplantation, bridge-to-candidacy, and destination therapies, it is imperative that the pre-operative indicators of RHF are identified and assessed. Multiple predictive models and parameters have been developed to quantify the risk of post-LVAD right heart failure. Clinical, laboratory, hemodynamic, and echocardiographic parameters have all been used to develop these predictive approaches. RHF remains a major cause of morbidity and mortality after LVAD implantation. Predicting RHF helps clinicians assess treatment options, including biventricular support or avoiding high-risk surgery. In our review, we noted the varying definitions for RHF in recent models, which affected respective predictive accuracies. The pulmonary arterial pulsatile index (PAPi) and right ventricular longitudinal strain parameters were noted for their potential to enhance current models incrementally. Meanwhile, mechanistic and machine learning approaches present a more fundamental shift in the approach to making progress in this field.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707615","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":"Preoperative Mechanical Ventilation Prior to Surgical Repair for Type A Aortic Dissection: Incidence, Risk, and Outcomes.","authors":"Angelo M Dell'Aquila, Konrad Wisniewski, Adrian-Iustin Georgevici, Gábor Szabó, Francesco Onorati, Till J Demal, Andreas Rukosujew, Sven Peterss, Caroline Radner, Joscha Buech, Antonio Fiore, Andrea Perrotti, Angel G Pinto, Javier Rodriguez Lega, Marek Pol, Petr Kacer, Enzo Mazzaro, Giuseppe Gatti, Igor Vendramin, Daniela Piani, Luisa Ferrante, Mauro Rinaldi, Eduard Quintana, Robert Pruna-Guillen, Dario Di Perna, Zein El-Dean, Hiwa Sherzad, Giovanni Mariscalco, Mark Field, Amer Harky, Manoj Kuduvalli, Matteo Pettinari, Stefano Rosato, Tatu Juvonen, Timo Mäkikallio, Lenard Conradi, Giorgio Mastroiacovo, Fausto Biancari","doi":"10.3390/jcdd12070239","DOIUrl":"https://doi.org/10.3390/jcdd12070239","url":null,"abstract":"<p><strong>Objectives: </strong>Several conditions associated with type A aortic dissection may require preoperative invasive mechanical ventilation (IMV). The current literature lacks data on this subset of patients' prevalence and postoperative outcomes. This study aims to investigate this unexplored issue in a multicenter European registry.</p><p><strong>Methods: </strong>Data from 3735 patients included in the European Registry of Type A Aortic Dissection (ERTAAD) were the subject of this analysis. Bootstrapped Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression was performed for variable selection to identify key predictors of hospital death. In the second step, a multilevel multivariable logistic regression (MMLR) was carried out, given the clustered structure of the data.</p><p><strong>Results: </strong>A total of 346 (9.3%) out of 3735 patients required preoperative IMV. Compared to the non-IMV patients, patients requiring IMV had a significantly higher rate of organ malperfusion (52% vs. 35%, <i>p</i> < 0.001) and a higher proportion of tears in the aortic root (<i>p</i> = 0.048). The in-hospital mortality rate among IMV patients was 38% vs. 15% in non-IMV patients (<i>p</i> < 0.001), without a difference in post-discharge survival (<i>p</i> = 0.84). At the MMLR, patients who required IMV had 135% higher odds of in-hospital death compared to the remaining patients. IMV yielded the second highest odds in the prediction model for in-hospital mortality (OR 2.13, CI 1.60 to 2.85, <i>p</i> < 0.001). Among IMV patients, the extension of surgery to the aortic arch was significantly associated with increased in-hospital mortality (<i>p</i> < 0.001, OR 2.98). In multivariable analysis, preoperative IMV was independently associated with increased odds of in-hospital mortality.</p><p><strong>Conclusions: </strong>The need for invasive mechanical ventilation before surgical repair for type A aortic dissection is not infrequent. In this subpopulation, the in-hospital mortality rate was twofold compared to patients who did not require IMV. The awareness of the preoperative risk profile and outcomes of this subset of patients should urge surgeons to tailor the surgical strategy more appropriately to improve the immediate postoperative results.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 7","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707616","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}