Journal of clinical gastroenterology最新文献

{"title":"Evaluating Hepatocellular Carcinoma Detection Scores: Moving Beyond the Receiver Operating Characteristic Curve.","authors":"Lu Xing, Mingying Leng, Xue Deng","doi":"10.1097/MCG.0000000000002444","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002444","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061459","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":"Orthostatic Intolerance in Patients With Disorders of Gut-Brain Interaction: A Systematic Review and Meta-Analysis.","authors":"Kana Ayaki, Ayesha Shah, Thomas Fairlie, Dmitrii Kulin, Kyle Staller, Samuel Nurko, Laurie Keefer, Qasim Aziz, Douglas A Drossman, Michael P Jones, Gerald Holtmann","doi":"10.1097/MCG.0000000000002443","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002443","url":null,"abstract":"<p><strong>Background: </strong>Patients with severe manifestations of disorders of gut-brain interaction (DGBI) have higher rates of concomitant Orthostatic Intolerance (OI) and Postural Orthostatic Tachycardia Syndrome (POTS). These conditions diminish quality of life and increase health care use. We conducted a systematic review to assess OI and POTS prevalence in patients with DGBI.</p><p><strong>Methods: </strong>Databases were searched through January 2026 for articles reporting the prevalence of OI and POTS among patients with DGBI. Pooled prevalence rates, odds ratios (ORs), and confidence intervals (CIs) were calculated using a random-effects model.</p><p><strong>Key results: </strong>Thirteen studies included 869 patients with DGBI and 1951 controls. OI prevalence in DGBI patients was DGBI (PP=50.0%, 95% CI: 35.0-64.9). The odds of OI in patients with DGBI were significantly higher compared with controls (OR=5.17, 95% CI: 1.73-15.50, P=0.003). Pediatric patients with DGBI had a higher prevalence of OI (59.7%, 95% CI: 36.4-79.3) than adults (32.5%, 95% CI: 19.3-49.4). The prevalence of OI in patients with DGBI was significantly higher when diagnosed using the Rome IV criteria (66.1%, 95% CI: 43.3-83.3) compared with the Rome III criteria (30.6%, 95% CI: 21.4-41.6). The prevalence of OI in DGBI was higher with questionnaire-based diagnosis (54.5%, 95% CI: 9.7-93.0) compared with physician-based diagnosis (48.8%, 95% CI: 35.2-62.7). Finally, POTS was prevalent in 31.5% (95% CI: 17.3-50.2) of patients with DGBI.</p><p><strong>Conclusions: </strong>OI is more prevalent in patients with DGBI as compared with controls without DGBI. POTS occurs in over one-third of patients with DGBI. While OI and DGBI are associated, clinical heterogeneity suggests low-quality evidence, warranting cautious interpretation.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061452","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":"Pharmacokinetic Predictor of Infection in Patients With Inflammatory Bowel Disease Treated With Intravenous and Subcutaneous Infliximab.","authors":"Ji Eun Kim, Sung Noh Hong, Eun Ran Kim, Dong Kyung Chang, Young-Ho Kim","doi":"10.1097/MCG.0000000000002431","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002431","url":null,"abstract":"<p><strong>Introduction: </strong>Infliximab (IFX) has significantly improved outcomes for patients with inflammatory bowel disease (IBD) but also predisposes them to infection. Preinfusion trough concentration (Ctrough) is commonly used in therapeutic drug monitoring (TDM) to optimize IFX efficacy. However, reliable pharmacokinetic (PK) or clinical factors predicting infection risk in IFX-treated IBD patients have not been well established.</p><p><strong>Methods: </strong>In a proactive TDM-based prospective cohort of IBD patients treated with intravenous (IV) or subcutaneous (SC) IFX, we collected Ctrough, anti-IFX antibody titers, demographic, clinical, and laboratory data at each 8-week visit. Cumulative IFX exposure for both IV and SC formulations, represented by the area under the concentration-time curve over 8 weeks (AUC0-8wk), was computed using a single validated population PK model. Logistic generalized linear mixed models (GLMM) with patient-level random intercepts were performed to assess associations between repeatedly measured PK parameters and infection risk.</p><p><strong>Results: </strong>Among 2451 visit-infection pairs (54% Crohn's disease; 29% SC dosing), 89 infections (3.6%) occurred. Although Ctrough was not associated with infection risk, random-intercept logistic GLMM analysis revealed that corticosteroid use (OR: 3.59, 95% CI: 1.08-11.90, P=0.037), low-dose immunomodulator use (OR: 0.51, 95% CI: 0.32-0.83, P=0.007), and AUC0-8wk (OR: 1.03 per 100 mg·d/L, 95% CI: 1.01-1.05, P=0.010) were associated with infection risk. Parallel generalized estimating equations yielded nearly identical effects. A parsimonious mixed-effects model confirmed AUC0-8wk as the primary predictor.</p><p><strong>Conclusion: </strong>Cumulative exposure, rather than Ctrough, predicts infection risk, supporting AUC monitoring for safer IFX dosing.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944869","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":"Sloughing Esophagitis: A Self-Limited Condition Associated With Debilitation and Polypharmacy? A Large Sample Analysis.","authors":"Anthony J Mauro, Aatur D Singhi, Kevin McGrath","doi":"10.1097/MCG.0000000000002442","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002442","url":null,"abstract":"<p><strong>Background: </strong>Sloughing esophagitis is thought to affect older, debilitated individuals, especially with comorbid disease. It classically exhibits white endoscopic plaques or membranes grossly and is diagnosed histologically by the sloughing of damaged cells with normal underlying mucosa.</p><p><strong>Goals: </strong>We sought to describe the clinical manifestations and associations of sloughing esophagitis in the largest cohort to date.</p><p><strong>Study: </strong>A large institutional database was searched for a diagnosis of sloughing esophagitis to identify patients. Corresponding endoscopy reports were reviewed. Historical and disease course data was extracted from the electronic medical record.</p><p><strong>Results: </strong>We identified 115 individuals with sloughing esophagitis. The most common EGD indication was dysphagia (31%). Classic endoscopic findings were present in 47%. The average Charlson comorbidity index score was 4.1, and individuals were prescribed 12.3 medications on average. SNF placement was recommended for 25 (22%) individuals, and 84 (78%) survived for ≥2 years following diagnosis. Symptoms and endoscopic findings resolved in 77% and 83% of cases, respectively, which was independent of treatment utilization.</p><p><strong>Discussion: </strong>Sloughing esophagitis has a variable endoscopic appearance and is associated with debilitation and polypharmacy. It may resolve spontaneously without pharmacotherapy, which may suggest a transient, self-limiting clinical course.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912312","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":"Global Action in Addressing the Challenge of Environmental Change and Digestive Health: A Report Card on Progress.","authors":"Anahita Sadeghi, Paria Boustani, Rui Morais, Desmond Leddin","doi":"10.1097/MCG.0000000000002438","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002438","url":null,"abstract":"<p><strong>Background: </strong>Environmental change is adversely affecting digestive health. Paradoxically, digestive health care contributes to the problem by generating emissions and waste. This study aimed to develop a set of metrics, a report card, to assess the response of the global digestive health community to this challenge.</p><p><strong>Methods: </strong>A survey was developed covering 26 actions that digestive health societies could take to reduce the environmental impact of digestive care. It was distributed to the leadership of national digestive health societies that are members of the World Gastroenterology Organization, as well as to 11 additional national societies. Five major international multisociety meetings were reviewed for sustainability practices. Positive responses were graded on a scale of A (81% to 100%) to E (0% to 20%). Four questions in the current survey were the same as those in a 2022 study, and the 2 sets were compared.</p><p><strong>Results: </strong>Forty-four responses were received from 121 invitations (36% response rate). Based on the number of positive responses to each sustainability metric, the global digestive health community received an overall grade of D or D-. There was no statistically significant difference between the 2022 survey data and current responses. Most major international meetings have successfully transitioned to hybrid formats, offering remote presentation options and digital archives to reduce travel-related emissions.</p><p><strong>Conclusion: </strong>The global digestive health community's response to the challenge of environmental change remains in its early stages. There is evidence of progress, especially in the change in the format of international meetings to include virtual attendance.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912356","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":"Temporal Trends in Mortality Related to Crohn's Disease in the United States: A 21-year Retrospective Analysis of CDC-WONDER Database.","authors":"Taha Bin Arif, Jawad Ahmad, Nimra Afzal, Mueez Ahmad Butt, Saman Afzal, Fawad Ahmad, Mohammad Ammar Ur Rahman, Luqman Munir, Asad Ur Rahman, Tahir Shaikh","doi":"10.1097/MCG.0000000000002209","DOIUrl":"10.1097/MCG.0000000000002209","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease is a chronic and debilitating inflammatory bowel disease that affects many people worldwide. This study explores mortality trends associated with Crohn's disease across various age groups, racial and ethnic backgrounds, urban and suburban settings, and census regions.</p><p><strong>Goals: </strong>By examining age-adjusted mortality rates (AAMRs), we identified the disparities in Crohn's disease-related mortality within demographic and geographic categories of the United States.</p><p><strong>Study: </strong>We analyzed death certificates from the CDC WONDER database (1999 to 2020), calculating AAMR per million people and annual percent change (APC) with 95% CIs. Trends by race, ethnicity, gender, age, census regions, and 2013 urbanization status were assessed using the Joinpoint Regression Program.</p><p><strong>Results: </strong>Between 2018 and 2020, Crohn's disease-related AAMRs rose sharply (APC 11.18, P =0.03). Most deaths occurred in medical inpatient settings (AAPC 0.228), but fatalities at home significantly increased (AAPC 5.37). After 2018, mortality rose in both men (APC 13.21) and women (APC 10.24). The Midwest had the highest rates (APC 0.56, P =0.04), while the Northeast saw a decline (1999 to 2017) followed by a sharp rise after 2017 (APC 9.64, P =0.0071). Mortality was higher in Whites but rose significantly in both Whites (APC 10.47) and African Americans (APC 20.62) post-2018, while trends among Hispanics showed no significant change.</p><p><strong>Conclusions: </strong>Marked demographic and geographic disparities, particularly the wide gap in AAMRs between Whites and African Americans, underscore the urgent need for targeted interventions, improved access to care, and more comprehensive research to reduce these inequities and enhance patient outcomes.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"735-742"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234298","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":"Beyond Efficacy: Interpreting the Clinical Implications of Proton Pump Inhibitors for Nocturnal GERD-related Sleep Disturbances.","authors":"Yun Liao, Yike Li, Lihua Feng","doi":"10.1097/MCG.0000000000002439","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002439","url":null,"abstract":"","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840289","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":"Transformer-Based Deep Learning Framework for Automated Lesion Detection in Capsule Endoscopy: A Comparative Study With CNN Architectures.","authors":"Sri Harsha Boppana, Sachin Sravan Kumar Komati, Aditya Chandrashekar, Gautam Maddineni, Sirisha Kundrapu, Nisheet Waghray, Marc Landsman, Venkata C K Sunkesula","doi":"10.1097/MCG.0000000000002432","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002432","url":null,"abstract":"<p><strong>Goals: </strong>To compare a vision transformer with 2 convolutional neural network architectures for multiclass lesion classification in capsule endoscopy images.</p><p><strong>Background: </strong>Manual review of capsule endoscopy is time-consuming and subject to interobserver variability. Deep learning can automate lesion recognition; however, most prior capsule endoscopy work evaluates a small number of classes, and systematic comparisons between transformer and convolutional architectures across many lesion categories are limited.</p><p><strong>Study: </strong>Two publicly available data sets (SEE-AI and Kvasir-Capsule) were merged and preprocessed to create a 21-class image data set (∼58,000 frames). Images were resized to 224 × 224 pixels and split using stratified sampling into training (n=40,587), validation (n=8696), and test (n=8696) sets. A pretrained Vision Transformer, DenseNet121, and ResNet50 were fine-tuned using categorical cross-entropy loss and Adam optimization, with early stopping. Performance was assessed using accuracy, macroaveraged precision, recall, F1 Score, and the area under the receiver operating characteristic curve.</p><p><strong>Results: </strong>On the independent test set, the vision transformer achieved 92.2% accuracy with macroaveraged precision/recall/F1-score of 0.92 and an area under the receiver operating characteristic curve of 0.99. DenseNet121 achieved 74.0% accuracy (F1-score 0.78; area under the receiver operating characteristic curve 0.85). ResNet50 achieved 38.0% accuracy (F1-score 0.40; area under the receiver operating characteristic curve 0.55).</p><p><strong>Conclusions: </strong>In this merged 21-class capsule endoscopy image data set, the vision transformer achieved higher frame-level classification performance than DenseNet121 and ResNet50 under the present experimental conditions. Importantly, the data set was split at the image level rather than at the patient or procedure level, because frames from the same examination may be correlated; therefore, performance figures likely reflect benchmark results on this frame-level public data set and should not be interpreted as estimates of patient-level generalization or as evidence of definitive architectural superiority. These findings support further evaluation of transformer-based approaches, but grouped reanalysis, external validation, and workflow-oriented studies are required before clinical implementation.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759726","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":"Real-World Study of Clinical Outcomes in Patients With Spontaneous Bacterial Peritonitis Receiving Albumin: Impact of Multidrug-Resistant Organisms From 2012 to 2022.","authors":"Nikki Duong, W Ray Kim, Elisabet Viayna, Thomas Ardiles, Kunal Lodaya, Jonathan Lilley, Nisha Wadhwani, Hayden W Hyatt, Rahul Rajkumar","doi":"10.1097/MCG.0000000000002426","DOIUrl":"https://doi.org/10.1097/MCG.0000000000002426","url":null,"abstract":"<p><strong>Background and goals: </strong>Spontaneous bacterial peritonitis (SBP) is a serious complication in patients with cirrhosis and ascites, with additional risks posed by multidrug-resistant organisms (MDRO). This real-world study evaluated clinical outcomes in patients with SBP and the impact of MDRO.</p><p><strong>Methods: </strong>This study identified US adults with SBP receiving guideline-recommended treatment with antibiotics and albumin from January 2012 to June 2022. Antibiotic utilization trends, health care resource utilization, and clinical outcomes [in-hospital and ICU mortality and hospital and ICU length of stay (LOS)] were assessed and stratified by MDRO status.</p><p><strong>Results: </strong>A total of 10,956 patients with 12,570 encounters were identified. Median age was 57.0 years (IQR=49.0 to 65.0), and 62.4% were male; suspected MDRO infections occurred in 15% of encounters. Third-generation cephalosporins were used in 71.6%, 49.2% had acute kidney injury, and 20.0% and 7.2% had hepatorenal syndrome and hepatic encephalopathy, respectively. Median hospital LOS was 7.2 days (IQR=4.3 to 12.9), with 17.7% in-hospital mortality. ICU care was required in 14.5% of encounters, with a median ICU LOS of 3.6 days (IQR=1.7 to 6.7) and ICU mortality of 29.7%. MDRO infections were associated with increased in-hospital mortality (OR=2.24, P<0.001) and decreased hazard of hospital discharge (ie, prolonged LOS; HR=0.43, P<0.001). Receiving albumin within 24 hours of admission was associated with a 72% higher hazard of hospital discharge (ie, shorter LOS; HR=1.72, P<0.001).</p><p><strong>Conclusion: </strong>This study highlights the clinical and resource burden of SBP, emphasizing the impact of MDRO infections and the importance of timely albumin administration concordant with clinical guidelines.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684672","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":"Comparative Outcomes After Index Myocardial Infarction in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.","authors":"Bachviet Nguyen, Stephanie Quon, Christopher Ma, Sunny Singh","doi":"10.1097/MCG.0000000000002372","DOIUrl":"10.1097/MCG.0000000000002372","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is a chronic systemic inflammatory disorder associated with elevated cardiovascular risk. While prior studies have linked IBD to increased risk of myocardial infarction (MI), post-MI outcomes in this population remain poorly characterized. We aimed to evaluate post-MI outcomes in patients with IBD compared with non-IBD controls.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted following PRISMA guidelines. Five databases were searched from inception to July 2025. We included observational studies comparing post-MI outcomes in adults with and without IBD. Random-effects meta-analyses were performed using hazard ratios (HRs) and odds ratios (ORs) with 95% CIs. Heterogeneity was assessed using the I2 statistic.</p><p><strong>Results: </strong>Nine retrospective cohort studies encompassing 9.45 million patients were included. IBD was associated with significantly increased risk of MACE (HR: 1.31, 95% CI: 1.07-1.59), all-cause mortality (HR: 1.25, 95% CI: 1.12-1.39), and recurrent MI (HR: 1.22, 95% CI: 1.08-1.39) following index myocardial infarction compared with non-IBD patients. Pooled ORs showed increased odds of major bleeding (OR: 1.38, 95% CI: 1.13-1.70) and transfusion (OR: 1.41, 95% CI: 1.35-1.47), but lower odds of heart failure (OR: 0.81, 95% CI: 0.74-0.89) and no significantly increased odds of stroke.</p><p><strong>Conclusions: </strong>Patients with IBD have statistically significantly higher risks of MACE, all-cause mortality, recurrent MI, blood transfusions, and major bleeding compared with the non-IBD population. These findings emphasize the potential role for tailored cardiovascular risk stratification, bleeding risk mitigation, and longitudinal management strategies in patients with IBD.</p>","PeriodicalId":15457,"journal":{"name":"Journal of clinical gastroenterology","volume":" ","pages":"603-612"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772810","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}