Journal of cardiology最新文献

{"title":"How to demonstrate the causal relationship between sodium-glucose cotransporter 2 receptor and prevention of ventricular arrhythmia in heart failure cohorts.","authors":"Naoya Kataoka, Teruhiko Imamura","doi":"10.1016/j.jjcc.2025.01.006","DOIUrl":"10.1016/j.jjcc.2025.01.006","url":null,"abstract":"","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023657","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":"Excimer LASER coronary atherectomy for ST-segment elevation myocardial infarction: Insights from a multicenter registry.","authors":"Yuji Matsuda, Taishi Yonetsu, Ken Kurihara, Shigeo Shimizu, Daisuke Ueshima, Hiroshi Inagaki, Yuko Onishi, Kaoru Sakurai, Takaaki Tsuchiyama, Takashi Ashikaga, Hiroyuki Fujii, Kazuo Kobayashi, Ikhtiyorjon Khamdamov, Yoshinori Kanno, Takayuki Niida, Yosuke Yamakami, Tomoyo Sugiyama, Tomoyuki Umemoto, Tsunekazu Kakuta, Tetsuo Sasano","doi":"10.1016/j.jjcc.2025.01.008","DOIUrl":"10.1016/j.jjcc.2025.01.008","url":null,"abstract":"<p><strong>Background: </strong>Excimer laser coronary atherectomy (ELCA) is used for thrombotic culprit lesions in ST-segment elevation myocardial infarction (STEMI), but its effectiveness is still unclear.</p><p><strong>Methods: </strong>Consecutive patients undergoing primary percutaneous coronary intervention within 24 h of onset were retrospectively investigated. Patients were divided into ELCA and non-ELCA groups. The primary endpoint was target vessel-related major adverse cardiac events (TV-MACE). Cox regression analysis and propensity score matching were performed to compare clinical outcomes between the two groups.</p><p><strong>Results: </strong>A total of 2593 patients were included in the analysis, with a median follow-up of 815 (390-1385) days. In the total cohort, there was no significant difference between the two groups in terms of TV-MACE-free survival rate. ELCA use was not a significant determinant of TV-MACE (hazard ratio 1.265, 95 % confidence interval, 0.910-1.757; p = 0.161). Nevertheless, when the ELCA group was stratified by the ELCA catheter size, the large catheter (1.4 mm-1.7 mm) group showed a lower event rate compared to the others in univariate analysis, although this difference was not significant in multivariate analysis. In the propensity score-matched cohort of 736 patients (368 pairs), the TV-MACE-free survival did not differ between the two groups.</p><p><strong>Conclusions: </strong>ELCA use was not associated with a reduced rate of adverse cardiac events in patients with STEMI. However, the use of large-sized ELCA catheters showed a potential association with better clinical outcomes, warranting further prospective studies.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023656","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":"Effect of cardiac rehabilitation on progression to long-term care: A clinical and economic longitudinal study in Japan.","authors":"Tomoyuki Takura, Arihiro Kiyosue, Teruyuki Koyama, Mitsuo Takei, Asao Honda","doi":"10.1016/j.jjcc.2025.01.005","DOIUrl":"10.1016/j.jjcc.2025.01.005","url":null,"abstract":"<p><strong>Background: </strong>The social burden of nursing care is increasing with age, particularly for patients with heart failure who often require intensive care. This study aimed to clarify the relationship between nursing care needs and the clinical status of patients with a history of cardiovascular disease, focusing on the benefits of cardiac rehabilitation (CR) in reducing these needs.</p><p><strong>Methods: </strong>This single-gate, multicenter, retrospective observational study included patients of all ages with a history of hospitalization for cardiovascular diseases using government-administered insurance claims and health examination data. Data spanning a four-year period (April 2014 to March 2018) were analyzed, and the effects of CR on nursing care needs and associated factors were examined. Multivariate analysis and propensity score matching were used to adjust for confounding factors, ensuring a robust comparison between CR and non-CR groups.</p><p><strong>Results: </strong>A total of 48,456 patients were enrolled, with an average follow-up of 36.1 months. After propensity score matching, patients who participated in CR demonstrated significantly lower mortality rates and reduced nursing care needs compared to those who did not (0.02 ± 0.13 vs. 0.04 ± 0.20, p < 0.01, 0.94 ± 0.27 vs. base: 1, p = 0.05). CR was associated with improved adherence to medications and increased generic drug prescriptions, contributing to better long-term health outcomes. The adjusted odds ratio for CR in reducing nursing care needs was 0.574 (95 % CI, 0.347-0.948, p < 0.05).</p><p><strong>Conclusions: </strong>This study confirms the potential critical role of CR in reducing mortality and nursing care needs in patients with cardiovascular disease. Although CR did not directly reduce nursing care costs, it contributed to improved health outcomes and reduced dependency on long-term care services. These findings highlight the benefits of CR as a preventive intervention, especially in aging populations. Further research is needed regarding its long-term economic benefits.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023655","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":"Surface steel ball calibration - A novel method for facilitating fluoroscopic measurement during implantation of WATCHMAN.","authors":"Feng Mao, Yijun Sun, Xianfeng Du, Guohua Fu, Fei Yu, Libin Chen, Yibo Yu, Mingjun Feng, Shengmin Zhang, Huimin Chu","doi":"10.1016/j.jjcc.2025.01.002","DOIUrl":"10.1016/j.jjcc.2025.01.002","url":null,"abstract":"<p><strong>Background: </strong>Although the method of autocalibration or calibration based on catheter diameters was proposed for fluoroscopic measurement during percutaneous left atrial appendage occlusion (LAAO), it may be imprecise and lead to mismeasurement. We sought to investigate whether the utilization of the surface steel ball calibration (SSBC) method under fluoroscopy could facilitate the fluoroscopic measurement of the post-implanted WATCHMAN device (Boston Scientific Corporation, Natick, MA, USA) in LAAO.</p><p><strong>Methods: </strong>This retrospective study included 97 consecutive patients who underwent percutaneous LAAO with the WATCHMAN device. The SSBC method and sheath calibration method under fluoroscopy, and transesophageal echocardiography (TEE) were employed to measure the diameter of the post-implanted device during the LAAO procedure. The results of the three methods were then compared.</p><p><strong>Results: </strong>The success rate for procedural WATCHMAN implantation was 100 %. The mean maximal diameter of the post-implanted devices was 24.7 ± 3.1 mm, 23.5 ± 3.2 mm, and 24.2 ± 3.0 mm, as measured by the SSBC method, sheath calibration method, and TEE, respectively (all p < 0.001). The relevant coefficient of correlation between the SSBC method/TEE, SSBC method/sheath calibration method, and TEE/sheath calibration method, was 0.94, 0.93, and 0.89, respectively (all p < 0.001).</p><p><strong>Conclusion: </strong>The SSBC method, when employed under fluoroscopy, demonstrated a high correlation with the sheath calibration method and TEE for measurements. It may be applied to facilitate fluoroscopic measurements during percutaneous LAAO procedures.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006184","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":"Association between delirium severity and prognosis following Transcatheter aortic valve implantation.","authors":"Tomohiro Suenaga, Kenichi Ishizu, Shinichi Shirai, Satoru Yoshida, Hayashi Wakugawa, Katsunori Miyahara, Ko Yamamoto, Akira Otani, Norihisa Miyawaki, Kenji Nakano, Euihong Ko, Yu Yoshino, Yasuo Tsuru, Miho Nakamura, Toru Morofuji, Masaomi Hayashi, Akihiro Isotani, Nobuhisa Ohno, Shinichi Kakumoto, Kenji Ando","doi":"10.1016/j.jjcc.2025.01.004","DOIUrl":"10.1016/j.jjcc.2025.01.004","url":null,"abstract":"<p><strong>Background: </strong>Delirium is associated with patient prognosis after transcatheter aortic valve implantation (TAVI). However, the prognostic impact of subsyndromal delirium, described as an intermediate stage between delirium and normal cognition, is uncertain. The present study aimed to investigate the prognostic impact of delirium severity in patients undergoing TAVI.</p><p><strong>Methods and results: </strong>We prospectively assessed the delirium status of 1617 consecutive patients who underwent TAVI at Kokura Memorial Hospital using the Intensive Care Delirium Screening Checklist (ICDSC). The patients were divided into the following three groups: no-delirium [ICDSC score 0, n = 1035 (64.0 %)], subsyndromal delirium [ICDSC 1-3, n = 348 (21.5 %)], and delirium [ICDSC 4-8, n = 234 (14.5 %)] groups. A worse delirium status was associated with older age, higher degree of frailty, and higher prevalence of comorbidities, including atrial fibrillation, dementia, and peripheral arterial disease. At 2 years post-procedure with a clinical follow-up rate of 92.6 %, the cumulative all-cause mortality rate was significantly higher in the subsyndromal delirium (21.8 %) (p < 0.001) and delirium (29.1 %) (p < 0.001) groups than in the no-delirium group (11.9 %). After adjusting for pre- and post-procedural confounders, subsyndromal delirium and delirium were associated with an increased mortality risk [adjusted hazard ratio (HR) for subsyndromal delirium, 1.38; 95 % CI, 1.00-1.90; p = 0.049; adjusted HR for delirium, 1.61; 95 % CI, 1.15-2.17; p = 0.006].</p><p><strong>Conclusions: </strong>Delirium conditions, including delirium and subsyndromal delirium, occurred in more than one-third of patients who had undergone TAVI and were associated with increased mortality.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006150","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":"Collaboration between dyspnea clinic and primary care physicians to identify heart failure with preserved ejection fraction in the community: Results from the Maebashi City HF project.","authors":"Naoki Yuasa, Satoshi Ubukata, Ryo Takayanagi, Eiji Yamashita, Keiji Hoshino, Yuta Tani, Takashi Kawashima, Hideki Ishii, Masaru Obokata","doi":"10.1016/j.jjcc.2025.01.001","DOIUrl":"https://doi.org/10.1016/j.jjcc.2025.01.001","url":null,"abstract":"<p><strong>Background: </strong>Despite increasing awareness in general practice, heart failure with preserved ejection fraction (HFpEF) remains under-diagnosed in the community due to diagnostic difficulties. Dedicated dyspnea clinics are responsible for diagnosing HFpEF and efficient referral from primary care physicians is the key to enhance its role.</p><p><strong>Methods: </strong>This retrospective analysis was performed to assess the effectiveness of a one-year collaborative project between our dyspnea clinic and the Maebashi Medical Association. Primary care physicians were encouraged to screen patients at risk for HFpEF and refer them to the dyspnea clinic, where exercise stress echocardiography was utilized to enhance the identification of HFpEF. To evaluate the clinical value of the project, the data obtained were compared with data from the previous year without collaboration.</p><p><strong>Results: </strong>The collaborative project was conducted between May 2023 and May 2024. The rate of patients referred from the city increased from 47 % during the previous year to 87 % during the collaborative period (p < 0.0001). Most of the patients were referred by non-cardiologists (77 %). The prevalence of HFpEF diagnosis tended to increase from 32 % to 39 % after the collaborative project, while pulmonary causes of dyspnea tended to decrease from 21 % to 12 %. After a thorough evaluation at the dyspnea clinic, 98 % of referred patients were referred back to their referring physicians for further treatment and follow-up.</p><p><strong>Conclusions: </strong>These data suggest the effectiveness of our approach to identify HFpEF in the community through collaboration between the dedicated dyspnea clinic and primary care physicians.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006154","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":"In-hospital mortality and risk factors in critically ill patients with hypertrophic cardiomyopathy.","authors":"Zhiyuan Ma, Jamshid Shirani","doi":"10.1016/j.jjcc.2025.01.003","DOIUrl":"https://doi.org/10.1016/j.jjcc.2025.01.003","url":null,"abstract":"<p><strong>Background: </strong>Hypertrophic cardiomyopathy (HCM) is a common genetic disease with estimated prevalence of 0.2-0.5 %. Contemporary management has substantially improved HCM outcomes. However, the impact of HCM on critically ill patients admitted to intensive care units (ICU) has not been well studied.</p><p><strong>Methods: </strong>Unmatched and propensity score matched patients with or without HCM were examined in the MIMIC-IV database and compared for mortality, morbidity, and length of stay. Multivariable logistic regression was used to identify risk factors associated with in-hospital mortality in patients with HCM.</p><p><strong>Results: </strong>Of 51,926 critically ill patients, 165 (0.32 %) were also diagnosed with HCM. Compared with those without HCM, patients with HCM had higher body mass index, higher rates of heart failure, atrial fibrillation, and chronic renal disease, and more often had implantable cardioverter defibrillators. There were no significant differences in in-hospital mortality (10.3 % vs 10.2 %) or length of stay (9.3 ± 9.6 vs 9.3 ± 1 0.6 days) between the two groups. Similar results were obtained in propensity score matched patients with or without HCM. Univariable analyses identified respiratory failure, sepsis, use of vasopressors, and circulatory support devices as predictors of in-hospital mortality in adults with HCM. In multivariable logistic regression analysis, respiratory failure and use of vasopressors and circulatory support devices were the predictors of in-hospital mortality in HCM patients.</p><p><strong>Conclusions: </strong>Presence of HCM did not affect in-hospital mortality in critically ill patients, but the need for vasopressors and circulatory support devices predicted worse in-hospital mortality among critically ill patients with HCM.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006156","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":"Coronary artery calcification as an incremental predictive risk: Research perspectives in primary prevention.","authors":"Alberto Cereda, Antonio G Franchina, Lorenzo Tua, Matteo Rocchetti, Davide Garattini, Emilia D'Elia, Stefano Lucreziotti","doi":"10.1016/j.jjcc.2024.12.005","DOIUrl":"https://doi.org/10.1016/j.jjcc.2024.12.005","url":null,"abstract":"<p><p>Coronary artery calcium (CAC) score is a neglected biomarker that can be derived from non-cardiac chest computed tomography scan and represents a surrogate for atherosclerosis. We created a simulation model using different CAC score values in the MESA coronary artery risk score in a population derived from the Fourier Trial. CAC score could modulate the sample sizes of cardiovascular trials in primary and secondary prevention and offer new primary prevention treatments to high-risk subjects with reasonable numbers needed to treat comparable to secondary prevention trials.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006155","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":"Contrast-associated acute kidney injury in patients with diabetes mellitus following elective percutaneous coronary intervention: Insights from an iodixanol-acute kidney injury registry study.","authors":"Yanbing Jiang, Song Li, Zaiyan Chen, Denglu Zhou, Qi Mao, Li Xiang, Ning Zhao, Zhe Zhang, Yinpin Zhou, Rong Zhang, Xiaohui Zhao","doi":"10.1016/j.jjcc.2024.12.006","DOIUrl":"https://doi.org/10.1016/j.jjcc.2024.12.006","url":null,"abstract":"<p><strong>Background: </strong>Patients with diabetes mellitus (DM) are particularly susceptible to contrast-associated acute kidney injury (CA-AKI). However, few studies have evaluated CA-AKI stages in patients with DM following elective percutaneous coronary intervention (PCI) with iodixanol.</p><p><strong>Methods: </strong>Patients with DM who underwent elective PCI in 8 Chinese hospitals from May 2020 to November 2021 were prospectively enrolled in the Iodixanol-Acute Kidney Injury Registry (No. ChiCTR1800016719). According to the European Society of Urogenital Radiation on their CA-AKI diagnosis, and follow-up of major adverse renal and cardiovascular events (MARCE), CA-AKI and prognosis predictors were identified using logistic and Cox multivariable regression, respectively.</p><p><strong>Results: </strong>There were 1120 patients with DM included and the incidence of CA-AKI was 5.8 % (65/1120). However, most CA-AKI patients were at acute kidney injury stage 1 (96.9 %, 63/65). The dose of iodixanol was not an independent risk factor for CA-AKI, however, a hemoglobin level <110 g/L, a left ventricular ejection fraction (LVEF) <40 %, an estimated glomerular filtration rate <60 mL/min/1.73m², an N-terminal pro-B-type natriuretic peptide level ≥300 pg/mL, and the use of loop diuretics were independent risk factors. Only 3.5 % (39/1120) of patients experienced MARCE. Hypertension, LVEF <40 %, hemoglobin level <110 g/L, and age >75 years old were independent risk factors for MARCE, while in comparison to indobufen, aspirin is an independent protective factor against MARCE in diabetic patients.</p><p><strong>Conclusions: </strong>The incidence of CA-AKI in patients with DM who underwent PCI was low, mostly associated with mild renal impairment, and therefore did not increase the risk of MARCE.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983594","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":"Right ventricular longitudinal strain in valvular heart disease: A comprehensive review.","authors":"Mana Ogawa, Asahiro Ito, Daiju Fukuda","doi":"10.1016/j.jjcc.2024.12.004","DOIUrl":"10.1016/j.jjcc.2024.12.004","url":null,"abstract":"<p><p>Right ventricular (RV) longitudinal strain has emerged as a crucial tool for evaluating RV systolic function in patients with heart disease. The complex anatomy of the RV presents challenges for functional assessment, traditionally conducted using conventional parameters, such as tricuspid annular plane systolic excursion and RV fractional area change. While these conventional methods are simple and practical, they have limitations in reflecting the majority of global RV systolic function. In contrast, RV longitudinal strain, measured using speckle tracking echocardiography, offers a more accurate evaluation of RV systolic function with high reproducibility. It is less dependent on angle and load and utilizes automated techniques. The utility of RV longitudinal strain in patients with valvular heart disease has been reported, showing its effectiveness in detecting early RV systolic dysfunction and providing valuable prognostic information compared to conventional methods. Treatment options for valvular heart disease include not only traditional open-heart surgery but also catheter-based interventions, which have become increasingly available in recent years. In addition to conventional risk assessment, considering treatment choices based on RV systolic function may be beneficial. This approach could provide a new method for determining the optimal treatment plan for individual patients. Despite challenges such as imaging quality and vendor-specific variability, RV longitudinal strain remains a valuable tool for early detection of RV systolic dysfunction, optimizing patient management, and improving outcomes. This review examines the clinical utility of RV longitudinal strain in patients with valvular heart disease, focusing on its prognostic value and role in patient management.</p>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931828","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}