Journal of Clinical Monitoring and Computing最新文献

{"title":"Does capnography improve safety in moderate-deep sedation for gastrointestinal endoscopic procedures provided by anaesthesiologists? A prospective cohort study.","authors":"Isabel Valbuena, Azahara Sancho, Estíbaliz Alsina, Nicolás Brogly, Fernando Gilsanz","doi":"10.1007/s10877-025-01299-7","DOIUrl":"10.1007/s10877-025-01299-7","url":null,"abstract":"<p><p>This study aimed to determine whether the use of capnography reduces the incidence of respiratory and cardiovascular adverse events during procedural sedation and analgesia (PSA) for gastrointestinal endoscopic procedures (GEP) provided by experienced anaesthesiologists. A prospective cohort study was conducted, including patients undergoing GEP under PSA. Patients were divided in two groups: Group A (pulse oximetry) and Group B (capnography with Capnostream^™ monitor plus pulse oximetry). Interventions undertaken to resolve hypoxaemia, airway obstruction, or apnoea were recorded. Age, comorbidities, ASA Classification, sedative drugs, respiratory and cardiovascular adverse events, recovery Aldrete Scale value, and patient satisfaction were also recorded. Both parametric and non-parametric tests were applied. A total of 1,146 patients were included: Group A, n = 538, and Group B, n = 608. Diagnostic colonoscopy was the most frecuent procedure (49.7%), followed by diagnostic gastroscopy (22.5%) and therapeutic colonoscopy (22.2%). Apnoea < 60 s was detected only in patients monitored with capnography (35.4% vs. 0%, p < 0.000). The use of capnography significantly reduced the incidence of moderate hypoxaemia (3% vs. 6.5%, p = 0.004). Severe hypoxaemia was significantly reduced with capnography only in patients with cardio-respiratory comorbidities (2.2% vs. 4.4%, p = 0.032). The capnography group showed a lower incidence of cardiovascular events. Respiratory adverse events, such as desaturation and airway obstruction, increased with age and ASA classification, as did the need for airway maneuvers. Prolonged apnoea and intubation were rare in both groups. Mandibular traction manoeuvres were significantly more frequent in Group B (9.9% vs. 3%, p < 0.000), reducing the need for other interventions. Patient satisfaction at discharge was higher when capnography was used (p < 0,000). Moderate-deep sedation for GEP performed by experienced anaesthesiologists, combined with capnography, enhances safety, with extremely rare major complications. Capnography monitoring allowed the timely identification and resolution of apnoea and airway obstruction, avoiding severe desaturation and cardiovascular adverse events.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"731-737"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142661","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":"Comment on \"Forecasting intraoperative hypotension during hepatobiliary surgery\".","authors":"Jiajing Wang","doi":"10.1007/s10877-025-01275-1","DOIUrl":"10.1007/s10877-025-01275-1","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"793-794"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572865","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":"Intraoperative PEEP selection by pressure-based capnography: a proof of concept study.","authors":"Gerardo Tusman, Matías Nicolás, Alejandro Carmona, Fernando Suarez Sipmann, Ulises Tusman, Peter Kremeier, Stephan H Böhm","doi":"10.1007/s10877-025-01318-7","DOIUrl":"10.1007/s10877-025-01318-7","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to test a new method to determine the positive-end expiratory pressure (PEEP) that maintains the lungs open after a recruitment maneuver (RM).</p><p><strong>Methods: </strong>In eleven anesthetized patients, we compared the standard RM searching for the optimal PEEP based on the highest respiratory compliance (PEEP_Crs), with a new method. This method performs a RM during a slow pressure-volume curve and detects the optimal PEEP using the novel barometric capnography curve (BCap); i.e. the plot of expired carbon dioxide versus airway pressure. The lungs' closing pressure was detected when the slope of phase III of the BCap changed along this slow expiration (PEEP_BCap). The main objective was to compare PEEP_BCap with the reference PEEP_Crs. As a secondary objective, we explored the association between PEEP_BCap and the polarity change in end-expiratory transpulmonary pressure (PEEP_PL) during the deflation phase of a slow flow PV curve.</p><p><strong>Results: </strong>We found a PEEP_BCap of 8.5(3.3) cmH₂O that was no statistically different from the PEEP_Crs of 10.0(4.0) cmH₂O (p = 0.72). Both methods correlated well with a Rho of 0.84 (p < 0.001). The Bland-Altman plot showed a bias of 0.19 and LOA of 1.92 cmH₂O (95%CI -0.39 to 0.77 cmH₂O). During the PV slow deflation limb, PEEP_PL was 9.3(4.3), which was statistically similar to PEEP_BCap (p = 0.61). Both pressures were strongly correlated (Rho = 0.93, p < 0.001) with a bias of -0.3 cmH₂O and LOA of 1.52 (95%CI -0.76 to 0.16 cmH₂O).</p><p><strong>Conclusions: </strong>We concluded that BCap is feasible to detect lungs collapse using a constant flow PV curve.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"739-744"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505859","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":"Feasibility and safety analysis of distal radial arterial catheterization for arterial pressure monitoring in ICU.","authors":"Jian Wang, Jie Zhang, Yi Zhang, Xianglan Liu, Chuanzhe Bai, Renlong Yu, Cheng Zhang, Xiaowen Qiu","doi":"10.1007/s10877-025-01313-y","DOIUrl":"10.1007/s10877-025-01313-y","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility and safety of distal radial artery (DRA) catheterization compared to conventional radial artery (CRA) catheterization for invasive arterial pressure monitoring in intensive care unit (ICU) patients.</p><p><strong>Methods: </strong>This single-center, prospective, randomized controlled study enrolled 197 ICU patients requiring invasive arterial pressure monitoring between May 2024 and March 2025. Patients were randomly assigned to either the DRA group (n = 99) or CRA group (n = 98). Primary outcome was first-attempt puncture success rate. Secondary outcomes included final success rate, catheterization time, compression time for hemostasis, abnormal waveform frequency, unplanned removal rate, and complications.</p><p><strong>Results: </strong>The DRA group demonstrated significantly lower first-attempt puncture success rates compared to the CRA group (68.69% vs. 82.65%, P = 0.022). With ultrasound assistance, final success rates were comparable between groups (98.99% vs. 97.96%, P = 0.993). Total catheterization time (133.61 ± 35.82s vs. 126.50 ± 36.99s, P = 0.175) and abnormal waveform frequency were similar between groups. The DRA group exhibited significantly shorter hemostasis times (224.45 ± 55.25s vs. 417.56 ± 71.32s, P < 0.001). Both groups had low complication rates with no statistically significant differences (1.01% vs. 3.06%, P = 0.621).</p><p><strong>Conclusion: </strong>Despite lower first-attempt success rates, DRA catheterization provides equivalent monitoring stability to CRA with significantly reduced hemostasis time and comparable safety profiles. DRA represents a viable alternative for invasive arterial pressure monitoring in ICU patients, particularly those requiring rapid hemostasis, preservation of forearm radial artery integrity, and patients in special positioning.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"767-774"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475473","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":"Heart rate variability as a marker of multiple organ dysfunction syndromes: a systematic review.","authors":"Anne Wojtanowski, Maxence Hureau, Mathieu Jeanne, Côme Bureau, Morgan Recher, Julien De Jonckheere","doi":"10.1007/s10877-025-01296-w","DOIUrl":"10.1007/s10877-025-01296-w","url":null,"abstract":"<p><p>Multiple organ dysfunction syndrome (MODS) can be caused by many factors. Assessments of the severity of MODS are currently based on occasional measurements of several clinical variables (laboratory data, vital signs, etc.). The analysis of heart rate variability (HRV) as a guide to autonomic nervous system activity might be of value in the continuous assessment of the severity of MODS. We systematically reviewed publications on the value of HRV variables for the diagnosis of MODS in patients of any age admitted to the ICU. Two investigators independently searched the PubMed, Embase, Cochrane and Science Direct databases for articles in English or French published between 2004 and 2024. Ten studies were included and rated for endpoint bias (MODS or mortality), using the revised Quality Assessment of Diagnostic Accuracy Studies. Nine studies assessed MODS, and six assessed mortality. All the studies evidenced low HRV in patients with MODS and in non-survivors. The results of our review show that HRV indices are influenced by the severity of MODS and might serve as a tool for predicting mortality in patients with MODS. However, patient characteristics, and treatments and HRV processing methods must be taken into account when interpreting the results. In order to clarify the impact of MODS on HRV variables, methodologically rigorous studies are now needed.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"717-729"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968402","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":"A smartphone application for semi-automated QT interval analysis based on a snapshot of an electrocardiogram trace displayed on a patient monitor.","authors":"David Beckmann, Moritz Flick, Karim Kouz, Bernd Saugel","doi":"10.1007/s10877-025-01277-z","DOIUrl":"10.1007/s10877-025-01277-z","url":null,"abstract":"<p><p>We developed a smartphone application (SMART-QT application) that can semi-automatically measure QT and QTc intervals based on a snapshot of the electrocardiogram (ECG) trace and the heart rate displayed on a patient monitor. In this study, we aimed to validate the SMART-QT application. In this prospective single-center method comparison study, we measured QT and QTc intervals with the SMART-QT application (QT_APP and QTc_APP; test method) and simultaneously manually measured QT and QTc intervals from a 12-lead ECG (QT_REF and QTc_REF; reference method) in 57 adult volunteers and patients who had sinus rhythm and no acute or chronic cardiac comorbidities. To investigate the agreement between QT_APP and QT_REF and between QTc_APP and QTc_REF, we performed Bland-Altman analyses and calculated the mean of the differences, the standard deviation, and the 95%-limits of agreement (95%-LOA). We defined clinically acceptable agreement as maximum mean of the differences ± standard deviation of 20 ± 20 ms. The mean of the differences between QT_APP and QT_REF was 14 ± 20 ms (95%-LOA -26 to 54 ms). The mean of the differences between QTc_APP and QTc_REF was 13 ± 15 ms (95%-LOA -16 to 42 ms). The agreement between QT_APP and QT_REF and between QTc_APP and QTc_REF was clinically acceptable in adult volunteers and patients without cardiac comorbidities.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"787-791"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002932","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":"Refining oxygen management through rigorous Oxygen Reserve Index (ORi) monitoring in patients undergoing general anesthesia: a randomized controlled trial : ORi to avoid excessive hyperoxia.","authors":"Tae Kwang Kim, Seok Hun Ko, Hye-Min Sohn","doi":"10.1007/s10877-025-01321-y","DOIUrl":"10.1007/s10877-025-01321-y","url":null,"abstract":"<p><p>Optimizing oxygenation for patients necessitates a delicate balance between sufficient oxygen delivery and mitigating the potential hazards of hyperoxemia. We hypothesized that integrating Oxygen Reserve Index (ORi) monitoring would effectively reduce intraoperative hyperoxemia compared to reliance solely on pulse oximetry. This single-center randomized controlled trial included multiple trauma patients with ASA class 3 or higher undergoing general anesthesia. FiO₂ adjustments to 0.5 started at T0 with arterial blood gas analysis (ABGA) every 30-minutes. Patients were randomized into Group O (ORi monitoring) and Group N (pulse oximetry). In Group O, FiO₂ was reduced if ORi > 0.05; unchanged if ORi was 0-0.05. Group N decreased FiO₂ if SpO₂ was 100%, unchanged if SpO₂ was < 99%, and increased FiO₂ by 0.05 until SpO₂ reached 95% or above. 54 participants were randomized, and 51 analyzed. Group O demonstrated a significantly higher percentage of normoxemia (80 ≤ PaO₂ < 120 mmHg) (64.4% vs. 40.4%, P = 0.002) across 181 ABGAs. Although baseline PaO₂ (T1) values were comparable within moderate hyperoxemia, at T2, only Group O achieved normoxemia, with consistently lower PaO₂ values at T2, T3, and T4 compared to Group N. ORi values in Group O consistently trended lower from T1 to T4. The positive correlation between PaO₂ and ORi was reaffirmed, establishing cut-off values for PaO₂ ≥ 120mmHg and ≥ 150mmHg at 0.06 and 0.22, respectively. Simultaneous ORi and pulse oximetry reduce intraoperative hyperoxemia through safe and meticulous protocol adherence in patients.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"745-755"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667749","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":"Influence of HeartMate 3™ on Bispectral Index™ monitor: a retrospective observational study.","authors":"Seiichi Azuma, Masaaki Asamoto, Shinichi Akabane, Mariko Ezaka, Mikiya Otsuji, Kanji Uchida","doi":"10.1007/s10877-025-01272-4","DOIUrl":"10.1007/s10877-025-01272-4","url":null,"abstract":"<p><p>Electroencephalogram-derived monitors are affected by various artifacts. HeartMate 3™ operates at frequency bands that overlap with those used for calculating the electromyographic index (EMG) and bispectral index (BIS) on the Bispectral Index™ monitor. This study investigated whether HeartMate 3 elevates these values, a change not predicted with HeartMate II™. This retrospective observational study included data from patients who underwent HeartMate 3 or II implantation between April 2008 and December 2023 as extracted from our institutional database. Patient-wise median EMG and BIS were compared between the pre-LVAD period (from the start of surgery to initiation of cardiopulmonary bypass) and the post-LVAD period (from the end of cardiopulmonary bypass to end of surgery). Data were obtained from 33 and 43 patients who underwent HeartMate 3 and HeartMate II implantation, respectively. Patients with HeartMate 3 implantation showed significant elevation in the EMG (pre-LVAD, mean ± standard deviation, 26.1 ± 1.0 dB; post-LVAD, 39.5 ± 2.8 dB; P < 0.001) without a significant change in the BIS (pre-LVAD, 44.5 ± 8.1; post-LVAD, 45.5 ± 7.1; P = 0.35). In contrast, patients with HeartMate II implantation did not show significant changes in either the EMG (pre-LVAD, 26.1 ± 1.2 dB; post-LVAD, 27.1 ± 4.1 dB; P = 0.16) or BIS (pre-LVAD, 45.1 ± 9.2; post-LVAD, 43.0 ± 8.1; P = 0.071). HeartMate 3 significantly elevates EMG. Anesthesiologists should be aware of this to appropriately interpret EMG elevation in patients with HeartMate 3.Trial registration: Japan Registry for Clinical Trials identifier: jRCT1030230549 (date of registration: January 10, 2024.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"669-680"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572870","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":"Intraoperative transcranial facial motor evoked potential in vestibular schwannoma reflects short-term post operative facial nerve function.","authors":"Yudai Morisaki, Ryosuke Matsuda, Tsunenori Takatani, Hironobu Hayashi, Ryuta Matsuoka, Yasushi Motoyama, Shohei Yokoyama, Fumihiko Nishimura, Kenta Nakase, Ichiro Nakagawa, Masahiko Kawaguchi, Hiroyuki Nakase","doi":"10.1007/s10877-025-01306-x","DOIUrl":"10.1007/s10877-025-01306-x","url":null,"abstract":"<p><p>Preservation of facial nerve function is extremely important in vestibular schwannoma surgery. Intraoperative transcranial facial motor evoked potential (Tc-fMEP) monitoring was used, and its accuracy and the correlations of Tc-fMEP results with postoperative facial nerve function at various time points were investigated. Factors associated with postoperative deterioration of facial nerve function were also examined. Forty-five consecutive cases of vestibular schwannoma that underwent surgery at our hospital from January 2013 to July 2022 were retrospectively reviewed. The correlation between intraoperative Tc-fMEP results and postoperative facial nerve function was investigated in each period from immediately after surgery to one year later. The warning criterion for Tc-fMEP was a decrease of 50% or more compared to the baseline amplitude. The relationships of age, sex, side, tumor size, and tumor nature with postoperative facial nerve function were also examined. Intraoperative Tc-fMEP monitoring was successfully performed in all 45 cases. Intraoperative Tc-fMEP results were significantly correlated with facial nerve function one week (P < 0.01) and one month after surgery (P < 0.01). The negative predictive value was 89% one month after surgery (P < 0.01). One year after surgery, the facial nerve function preservation rate (House and Brackmann: grade I-II) was 88%. In addition, facial nerve function one year after surgery was significantly worse with cystic tumors than with solid tumors (P = 0.04). Intraoperative Tc-fMEP monitoring may reflect facial nerve function one week to one month after surgery. In addition, in our study cystic tumors had significantly higher deterioration in postoperative facial nerve function than for solid tumors.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"697-705"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225637","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":"Entropy of difference works similarly to permutation entropy for the assessment of anesthesia and sleep EEG despite the lower computational effort.","authors":"Alexander Edthofer, Dina Ettel, Gerhard Schneider, Andreas Körner, Matthias Kreuzer","doi":"10.1007/s10877-024-01258-8","DOIUrl":"10.1007/s10877-024-01258-8","url":null,"abstract":"<p><p>EEG monitoring during anesthesia or for diagnosing sleep disorders is a common standard. Different approaches for measuring the important information of this biosignal are used. The most often and efficient one for entropic parameters is permutation entropy as it can distinguish the vigilance states in the different settings. Due to high calculation times, it has mostly been used for low orders, although it shows good results even for higher orders. Entropy of difference has a similar way of extracting information from the EEG as permutation entropy. Both parameters and different algorithms for encoding the associated patterns in the signal are described. The runtimes of both entropic measures are compared, not only for the needed encoding but also for calculating the value itself. The mutual information that both parameters extract is measured with the AUC for a linear discriminant analysis classifier. Entropy of difference shows a smaller calculation time than permutation entropy. The reduction is much larger for higher orders, some of them can even only be computed with the entropy of difference. The distinguishing of the vigilance states between both measures is similar as the AUC values for the classification do not differ significantly. As the runtimes for the entropy of difference are smaller than for the permutation entropy, even though the performance stays the same, we state the entropy of difference could be a useful method for analyzing EEG data. Higher orders of entropic features may also be investigated better and more easily.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"655-668"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894841","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}