Diabetes, Obesity & Metabolism最新文献

{"title":"Tirzepatide in the NHS: The known unknowns of treating obesity at a national scale.","authors":"Ashley Kieran Clift, Nadja Auerbach, Vivian N Liu, Hans Johnson, Thomas Curtis, David R Huang","doi":"10.1111/dom.16375","DOIUrl":"https://doi.org/10.1111/dom.16375","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world evidence on the utilization, clinical and comparative effectiveness, and adverse effects of newer GLP-1RA-based weight-loss therapies","authors":"Reimar W. Thomsen PhD, Aurélie Mailhac MSc, Julie B. Løhde MD, Anton Pottegård DMSc","doi":"10.1111/dom.16364","DOIUrl":"10.1111/dom.16364","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as key agents for weight management, based on their marked efficacy as observed in randomized controlled trials. While still limited, real-world studies on GLP-1RA use in populations with obesity are increasingly available. This narrative review discusses contemporary real-world evidence demonstrating the utilization, clinical and comparative effectiveness, and adverse effects of the currently approved GLP-1RA-based weight-loss therapies, that is, liraglutide, semaglutide and tirzepatide. The observed weight reduction in clinical practice overall tends to be lower than in randomized controlled trials; however, outcomes approach those seen in trials when focusing on highly adherent patients. Real-world studies demonstrate high discontinuation rates of GLP-1RAs (20%–50%) within the first year, and the use of much lower doses than those evaluated in clinical trials. Evidence from observational studies within type 2 diabetes or obesity populations suggests frequent gastrointestinal disturbances in GLP-1RA users, as also observed in trials, but no clear increase in risks of severe events like pancreatitis or pancreatic cancer, thyroid disorders, or depression and self-harm. Further evidence is needed to understand possible real-world associations of GLP-1RAs with eye disease and other rare outcomes. We provide 10 areas of particular importance for further research on GLP-1RA within the real-world space, including improved understanding of the exact drivers of early discontinuation and suboptimal dosing, studies of the effects of stopping GLP-1RA treatment, and investigations of clinical and cost-effectiveness for hard clinical outcomes in real-world settings, including not only cardio-reno-metabolic outcomes but also obesity-induced diseases like neuropsychiatric disease, cancer, musculoskeletal disease, and infections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain Language Summary</h3>\u0000 \u0000 <p>Recent advancements in weight-loss medications have sparked a lot of interest. The so-called GLP-1 receptor agonist medications (GLP-1RAs) have gained a lot of attention, because they have shown to be very effective, leading to significant weight loss in patients participating in clinical trials. GLP-1RAs, like liraglutide, semaglutide, and tirzepatide, help manage weight by mimicking hormones that control blood sugar and appetite. However, how these medications perform in real life can be different from the controlled settings of clinical trials, in which patients are carefully selected and their treatment plans closely followed. This literature review looks at how these medications are used and their effectiveness and safety in real-world settings. In real-life practice, GLP-1RAs are often less effective than in clinical t","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 S2","pages":"66-88"},"PeriodicalIF":5.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.16364","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of different functional hydrogel dressings in healing diabetic foot ulcer: A systematic review and network meta-analysis.","authors":"Xiaozhen Zhou, Shida Chen, Benjamin Savitz, Nanze Yu, Galen Perdikis, Kylie Duckworth, Yomna Dean, Xiao Long, William Lineaweaver","doi":"10.1111/dom.16367","DOIUrl":"https://doi.org/10.1111/dom.16367","url":null,"abstract":"<p><strong>Aims: </strong>Functional hydrogel dressings offer a promising therapeutic approach, and optimizing their formulations is crucial for improving diabetic foot ulcers (DFUs) outcomes. This study explores the comparative efficacy of different functional hydrogel dressings in DFUs treatment.</p><p><strong>Materials and methods: </strong>We conducted a systematic review and Bayesian network meta-analysis of randomized controlled trials evaluating functional hydrogel dressings for DFUs treatment. A comprehensive search was performed across PubMed, Embase, CENTRAL, CNKI and Web of Science from inception to June 2024. Bayesian network meta-analysis was employed to synthesize and compare the relative efficacy of hydrogel interventions, defined as the number of patients with complete wound closure.</p><p><strong>Results: </strong>In total, 23 studies involving 1671 patients with DFUs were included. The analysis revealed that immuno-regulating hydrogels (IRHs) had the highest effect estimate (2.2, 95% CI: 1.6, 3.2), compared with anti-bacterial hydrogels (ABHs) ranked last (1.3, 95% CI: 0.78, 2.3). Multi-functional hydrogels (MFHs) and proliferation-promoting hydrogels (PPHs) displayed intermediate effects (1.7, 95% CI: 1.2, 2.4). The relative efficacy ranking was IRH > MFH/PPH > ABH > placebo. The risk of adverse events was lower in functional hydrogel groups relative to placebo (0.75, 95% CI: 0.56, 0.96). Node-splitting analysis confirmed the consistency between direct and indirect evidence for IRH versus ABH. A funnel plot analysis indicated no significant publication bias, affirming the robustness of our findings.</p><p><strong>Conclusion: </strong>This study provides a comprehensive evaluation of functional hydrogel dressings for DFUs treatment, highlighting the potential of IRH as the most effective option. These insights will guide future research and clinical applications to improve DFUs management.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Cumulative risk of diabetic foot complications in risk groups of type 1 and type 2 diabetes: Real-world evidence from a 22-year follow-up study\".","authors":"","doi":"10.1111/dom.16381","DOIUrl":"https://doi.org/10.1111/dom.16381","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of overweight and obesity in adults from the Middle East: A large-scale population-based study.","authors":"Elamin Abdelgadir, Fauzia Rashid, Alaaeldin Bashier, Marwan Zidan, Barbara McGowan, Fatheya Alawadi","doi":"10.1111/dom.16389","DOIUrl":"https://doi.org/10.1111/dom.16389","url":null,"abstract":"<p><strong>Aims: </strong>Although there are population-level estimates of the prevalence of overweight and obesity (OAO), there are few direct epidemiological surveys of OAO prevalence at scale.</p><p><strong>Materials and methods: </strong>This was a cross-sectional, multi-centre, population-based study of all adults aged >18 years attending the Dubai Academic Health Corporation (DAHC) between January 2018 and August 2023. OAO was defined according to WHO standards or modified WHO cut points for individuals from WHO South-East Asian Region (SEAR) countries. Clinical obesity, defined according to new Lancet Commission diagnostic criteria, was estimated using ICD-10 codes corresponding to end-organ dysfunction.</p><p><strong>Results: </strong>Of 440 590 participants, 48.5% were female, 52% were aged 19-39 years and 37.1% were UAE nationals. 63.4% of the population were living with OAO. Significantly more UAE nationals (68.3%) were living with OAO than nationals from SEAR countries (59.7%, p < 0.001) or elsewhere (63.6%, respectively, p < 0.001). Significantly more females than males were living with obesity (30.4% vs. 25.9%, p < 0.001). About a half of female UAE nationals aged ≥40 years were living with obesity, about one in five of whom had class 2 or class 3 obesity. Using modified ethnicity-specific thresholds increased the overall proportion of people living with obesity in the UAE from 28.0% to 35.8%. About a third of individuals with a body mass index ≥40 kg/m² also had signs or symptoms of ongoing organ dysfunction classifiable as clinical obesity.</p><p><strong>Conclusions: </strong>This is the largest epidemiological study to provide direct prevalence data on OAO at this scale in the region and one of the largest globally. Using standard WHO cut points to define OAO may severely underestimate the prevalence of clinically actionable obesity in individuals of Southeast Asian ethnicity. This first application of new diagnostic criteria of clinical obesity suggests that some individuals may be disqualified from therapy who might otherwise benefit from a patient-centric approach.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of the safety of sodium-glucose co-transporter-2 inhibitors.","authors":"Daniel Vincent O'Hara, Meg J Jardine","doi":"10.1111/dom.16385","DOIUrl":"https://doi.org/10.1111/dom.16385","url":null,"abstract":"<p><p>The development of sodium-glucose co-transporter-2 (SGLT2) inhibitors represents a major turning point in the effort to preserve kidney function and prevent cardiovascular events and heart failure hospitalisations in those at high risk. These agents have now transcended their original glucose-lowering indication and provide a range of clinical benefits in people both with and without diabetes, and at varying levels of kidney function. Despite this, SGLT2 inhibitors remain underutilized by the medical community. One potential barrier to improved uptake may be concern about adverse effects. The following review summarizes the wealth of information garnered from clinical trials and real-world data in recent years to examine the safety of SGLT2 inhibitors and to provide practical advice to promote safer use of these important therapies.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis of randomized controlled trials for the development of the International Federation for Surgery of Obesity and Metabolic Disorders-European Chapter (IFSO-EC) guidelines on multimodal strategies for the surgical treatment of obesity.","authors":"Maurizio De Luca, Amanda Belluzzi, Luigi Angrisani, Giulia Bandini, Barbara Becattini, Marco Bueter, Francesco Maria Carrano, Sonja Chiappetta, Ricardo V Cohen, Catalin Copaescu, Nicola Di Lorenzo, Marloes Emous, Daniel Moritz Felsenreich, Martin Fried, Jacques Himpens, Antonio Iannelli, Giuseppe Navarra, Simon Nienhuijs, Stefano Olmi, Chetan Parmar, Gerhard Prager, Juan Pujol-Rafols, Benedetta Ragghianti, Rui Ribeiro, Elena Ruiz-Úcar, Nasser Sakran, Paulina Salminen, Daniele Scoccimarro, Erik Stenberg, Christine Stier, Halit Eren Taskin, Ramón Vilallonga Puy, Matteo Monami","doi":"10.1111/dom.16352","DOIUrl":"https://doi.org/10.1111/dom.16352","url":null,"abstract":"<p><strong>Background: </strong>Randomized, controlled trials (RCTs) comparing the effectiveness of metabolic bariatric surgery (MBS) in addition to one or more treatment interventions for obesity (i.e., lifestyle structured interventions-LSI, medical therapy-MT, obesity management medication-OMM or endobariatric procedures-EP) are lacking. This study aims to assess the effectiveness of multiple simultaneous (before or immediately after MBS) interventions for treating obesity.</p><p><strong>Methods: </strong>We performed a meta-analysis including all RCTs enrolling patients undergoing different MBS procedures add-on to other anti-obesity strategies (LSI, MT, OMM or ES) versus MBS alone, with a duration of at least 6 months. The primary outcome was BMI at the end-point; secondary end-points included percentage total and excess weight loss (%TWL%, and EBWL%), total weight loss (TWL), fasting plasma glucose (FPG), HbA1c, surgical and non-surgical severe adverse events (SAE), mortality, remission of type 2 diabetes, hypertension, dyslipidemia and health-related quality of life (HR-QoL).</p><p><strong>Results: </strong>A total of 25 RCTs were retrieved. The addition of either OMM (i.e., liraglutide) or EP (i.e., intragastric balloon-IB, endosleeve-ES) to MBS was associated with a significantly lower BMI at the end-point (p = 0.040). The addition of liraglutide only to MBS was associated with a greater %EWL%, but not %TWL and TBWL (p = 0.008). Three trials evaluated end-point HbA1c, showing a significant reduction in favour of liraglutide as an add-on therapy to MBS (p = 0.007). There was no mortality.</p><p><strong>Conclusions: </strong>MBS combined with non-surgical approaches appears more effective than MBS alone in reducing BMI. Further RCTs on combined therapies to MBS for severe obesity are needed to enhance the tailoring of treatment for severe obesity.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of tirzepatide with glycaemic control and weight loss in a real world cohort of patients with type 2 diabetes from the United States.","authors":"Reema Mody, Karishma Desai, Chia-Chen Teng, Gally Reznor, Grace Stockbower, Michael Grabner, Brian D Benneyworth","doi":"10.1111/dom.16372","DOIUrl":"https://doi.org/10.1111/dom.16372","url":null,"abstract":"<p><strong>Aims: </strong>The goal of this observational, single-cohort, pre-post study was to describe the association of tirzepatide with glycaemic control and weight loss in patients with type 2 diabetes (T2D) in a US commercially insured population.</p><p><strong>Materials and methods: </strong>Using the Healthcare Integrated Research Database (HIRD®), members ≥18 years, diagnosed with T2D, initiating tirzepatide between 13 May 2022 and 31 January 2023, with ≥1 glycated haemoglobin (HbA1c) result around the index date and the end of the 6-month follow-up period were identified. Baseline demographics and antihyperglycaemic medication use and key outcomes (HbA1c and weight) at 6-month follow-up were assessed overall and in subgroups stratified by baseline glucagon-like peptide-1 (GLP-1) receptor agonist (RA) use and HbA1c (<7% and ≥7%) level.</p><p><strong>Results: </strong>The cohort of 2247 identified patients was primarily non-Hispanic White, female (58%), 54 years old, 54% had GLP-1 RA at baseline, 59% had an HbA1c ≥7% at baseline and 61% had overweight/obesity. At 6-month follow-up, a majority of the cohort (69%) had an HbA1c <7%, which was higher (77%) in the GLP-1 RA naïve subgroup. Mean change in weight was: -6.3 kg for the overall cohort; -7.1 kg in patients with baseline HbA1c <7%; and -8.1 kg in the GLP-1 RA naïve subgroup.</p><p><strong>Conclusion: </strong>In this observational, single-cohort study, at 6-month follow-up, patients with T2D initiating tirzepatide showed HbA1c and weight reductions; more pronounced HbA1c reductions occurred in GLP-1 RA naïve patients or those with baseline HbA1c ≥7%, while more weight loss was observed among GLP-1 RA naïve patients or those with baseline HbA1c <7%.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-cell transcriptional profiling reveals cellular senescence and inflammatory persistence as key features of type 1 diabetes partial remission.","authors":"Ruiqiang Xie, Tianhao Li, Hong Gao, Chunguang Xie, Haipo Yuan, Zhijun Feng","doi":"10.1111/dom.16384","DOIUrl":"https://doi.org/10.1111/dom.16384","url":null,"abstract":"<p><strong>Aims: </strong>To investigate the underlying immune mechanisms during partial remission (PR) in type 1 diabetes (T1D) using single-cell RNA sequencing of peripheral blood mononuclear cells from healthy controls, newly diagnosed T1D patients, and those in the PR stage.</p><p><strong>Materials and methods: </strong>We performed integrated analysis combining differential expression analysis, trajectory inference, cellular senescence evaluation and transcriptional network reconstruction to characterize monocyte heterogeneity and dynamic changes during disease progression. We identified five distinct monocyte subsets with unique molecular signatures and demonstrated their stage-specific alterations.</p><p><strong>Results: </strong>The PR stage was characterized by persistent inflammatory responses, evidenced by the expansion of IL1B+ monocytes and sustained activation of TNF and IL6-STAT3 signalling pathways, while HDAC9+ populations showed significant reduction. Notably, the PR stage exhibited marked accumulation of senescent cells across monocyte subsets, demonstrated by elevated senescence-associated secretory phenotype scores and increased P21 expression. Trajectory analysis revealed altered developmental dynamics during PR, with distinct classical and non-classical monocyte branches. Transcriptional network analysis identified sustained activation of EGR1 and NFκB signalling throughout disease progression, particularly during PR.</p><p><strong>Conclusion: </strong>These findings reveal previously unrecognized features of immune dysregulation during PR and provide potential therapeutic targets for T1D treatment.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneous effects of obesity on all-cause mortality: A causal forest analysis of hospitalized patients in China.","authors":"Menghui Liu, Zemeihong Xu, Lixiang He, Xingfeng Xu, Xiaojie Cai, Yue Guo, Shaozhao Zhang, Xinghao Xu, Zhenyu Xiong, Xiaodong Zhuang, Xinxue Liao","doi":"10.1111/dom.16391","DOIUrl":"https://doi.org/10.1111/dom.16391","url":null,"abstract":"<p><strong>Aims: </strong>To confirm the 'obesity paradox' in hospitalized populations and examine the heterogeneous effects of obesity on all-cause mortality risk.</p><p><strong>Materials and methods: </strong>We included 5967 hospitalized patients from the Real-world Data of Cardiometabolic Protection (RED-CARPET) study (ChiCTR2000039901) in China. After 1:1 k-nearest neighbours matching, a causal forest model classified the population into four subgroups. Cox models were used to assess the association between obesity and all-cause mortality, with external validation in the Atherosclerosis Risk in Communities (ARIC) cohort.</p><p><strong>Results: </strong>During a median follow-up of 63.8 months, 919 (15.4%) deaths occurred. A U-shaped association between body mass index (BMI) and all-cause mortality was observed, illustrating the 'obesity paradox', with the highest mortality rate (18.5%) observed in the normal weight group. Furthermore, 911 participants with obesity and 911 participants with normal weight, matched for homogeneity, were categorized into four subgroups using the causal forest model. In subgroup 3 (with good renal function, well-controlled blood glucose and favourable nutritional status), patients with obesity had a higher risk of all-cause mortality compared to those with normal weight (HR, 2.12; 95% CI, 1.06-4.22; p = 0.033). No significant association was observed in the other subgroups (p > 0.05). Similar results were verified in the ARIC study cohort.</p><p><strong>Conclusions: </strong>The association between obesity and all-cause mortality is heterogeneous, as individuals with good renal function, well-controlled blood glucose and favourable nutritional status may experience a higher mortality risk. These findings emphasize the need for personalized management strategies in clinical practice to address the varying effects of obesity across different health conditions.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}