Journal of Intensive Care Medicine最新文献

{"title":"Risk Factors Associated with the Onset of Atrial Fibrillation in Patients with Sepsis and Septic Shock in Intensive Care Units.","authors":"Alejandro Narváez, Cristian Agudelo, Clara Saldarriaga, Mariana Jimenez, Maria Robledo, Valentina Duque, Melissa Mejía, Violeta Cano, Camilo Lopez, Nicolas Arcila, Francisco Villegas, Fabian Jaimes","doi":"10.1177/08850666251412802","DOIUrl":"10.1177/08850666251412802","url":null,"abstract":"<p><p>IntroductionNew-onset atrial fibrillation (AF) in sepsis is a common complication in critically ill patients and carries significant prognostic implications. Although multiple risk factors have been associated with its development, findings remain inconsistent, and data from Latin American populations are scarce. This study aimed to evaluate the association between clinical variables of sepsis and the development of new-onset atrial fibrillation (AF) in patients admitted to intensive care units (ICUs).MethodsA retrospective cohort study was conducted across three referral hospitals in Medellín, Colombia, between January 2022 and June 2023. Adult patients admitted to the ICU with a diagnosis of sepsis or septic shock, defined according to the SEPSIS-3 criteria, were included. Infection-related clinical variables were measured, and the primary outcome was the development of new-onset AF. A multivariable analysis was performed using adjusted binomial logistic regression.ResultsA total of 1356 patients were included, with a mean age of 64.3 years; 67.7% were male. The prevalence of new-onset AF was 12.6% (n = 171). In the multivariable analysis higher SOFA scores and the use of noninvasive mechanical ventilation or vasoactive drugs were associated with its development. In the multivariable analysis adjusted for confounding variables, only the use of dual vasopressor support (OR 2.7; 95% CI, 1.1-7.35) and the use of any inotrope (OR 4.02; 95% CI, 1.3-11.65) were significantly associated with the development of AF. Patients who developed AF exhibited higher ICU mortality (49% vs 34%) and in-hospital mortality (55% vs 37%).ConclusionNew-onset AF in sepsis is common among ICU patients. Use of dual vasopressor support and any inotropic agent were consistently associated with its occurrence.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"853-862"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145998387","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":"To the Editor: Severe Necrotizing Lung Infections: Definitions and Therapeutic Indications.","authors":"George Rakovich, Sebastian G Kurz","doi":"10.1177/08850666261453827","DOIUrl":"10.1177/08850666261453827","url":null,"abstract":"","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"916"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148330368","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":"The Use of Vasoactive Agents in Pulmonary Embolism Among the Critically Ill: A Multi-Centred, Retrospective Cohort Study in Queensland Intensive Care Units.","authors":"Ashton Moh, Felicity Edwards, Prashanti Marella, Jayshree Lavana, Andrea Marshall, Alexis Tabah, Kyle White, Sebastiaan Blank, Stephen Whebell, Stephen Luke, Peter Garrett, Hayden White, Kevin Laupland, Antony Attokaran, Mahesh Ramanan","doi":"10.1177/08850666251415168","DOIUrl":"10.1177/08850666251415168","url":null,"abstract":"<p><p>BackgroundPulmonary embolism may cause hemodynamic instability requiring vasoactive support, but evidence on guiding agent selection is very limited.MethodsA retrospective cohort study of adult admissions to 12 Intensive Care Units in Queensland, Australia between 2015-2021. Clinical and outcome data was obtained through statewide hospital databases.ResultsOf 89,123 admissions, 460 (0.6%) patients had a primary diagnosis of pulmonary embolism. Vasoactive infusions were administered within the first 24 h of ICU admission to 182/460 patients (39.6%) and 209/460 (45.4%) patients at any time during ICU admission. Norepinephrine was the most common (175/209; 83.7%), followed by epinephrine (37/209; 17.7%). The cohort had a median ICU length of stay of 3 days (IQR; 2-5), and a 30-day mortality rate of 11.3% (52/460). Higher vasoactive requirement on day-1 was associated with significantly higher 30-day mortality (odds ratio per 1-unit increase in vasoactive-inotrope score of 3.72, 95% confidence interval 1.80-8.75, P < .001).ConclusionPrimary diagnosis of PE is uncommon among ICU presentations but 45% of patients require vasoactive support. Norepinephrine was the most used vasoactive agent. Higher vasoactive requirements reflected greater illness severity and were associated with higher 30-day mortality.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"863-873"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018673","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":"The Immunomodulatory Effects of Nutritional Supplements in Traumatic Brain Injury.","authors":"Christian Zanza, Yaroslava Longhitano, Raymond Planinsic, Antonio Voza, Manfredi Tesauro, Giorgia Caputo, Francesca Rubulotta, Luigi La Via","doi":"10.1177/08850666251337378","DOIUrl":"10.1177/08850666251337378","url":null,"abstract":"<p><p>Traumatic brain injury (TBI) remains a leading cause of mortality and disability worldwide, characterized by complex pathophysiological processes that extend beyond the initial trauma. The inflammatory response following TBI plays a crucial role in patient outcomes, presenting both protective and potentially detrimental effects. This narrative review examines the current evidence regarding the role of nutritional supplements in modulating the inflammatory response after TBI. Recent research has demonstrated that various nutritional interventions, including probiotics, immunonutrition formulas, vitamin D, and taurine supplementation, can significantly influence inflammatory markers and clinical outcomes. Probiotics have shown particular promise in reducing inflammatory mediators and infection rates, while also decreasing hospital and ICU length of stay. Immunonutrition, especially through vitamin D supplementation, demonstrates significant effects on consciousness levels and ventilation requirements. The timing of nutritional intervention emerges as critical, with the early post-injury period (24-72 h) representing a crucial window for therapeutic intervention. The gut-brain axis appears central to these effects, with nutritional supplements potentially modulating both central and systemic inflammatory responses. While these interventions show promising results in reducing inflammatory markers and improving short-term outcomes, their impact on mortality rates remains limited. Future research should focus on optimizing nutritional protocols, understanding individual patient factors, and investigating long-term functional outcomes. This review supports a paradigm shift in approaching nutritional support in TBI, transitioning from viewing it as merely supportive care to recognizing it as an active therapeutic intervention that can significantly influence patient outcomes.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"807-813"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028438","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":"The Superiority of AVAPS Mode of Non-invasive Ventilation in Combination with HFNC Over HFNC Alone in Patients with Chronic Obstructive Pulmonary Disease Complicated by Respiratory Failure.","authors":"Jiaojiao Yang, Bingyan Ren, Chunmei Yu, Fenfen Chen, Guixiang Qin","doi":"10.1177/08850666251412806","DOIUrl":"10.1177/08850666251412806","url":null,"abstract":"<p><p>ObjectiveThis paper was designed to investigate the clinical efficacy of combining the Average Volume Assured Pressure Support (AVAPS) mode of non-invasive ventilation (NIV) with high-flow nasal cannula oxygenation (HFNC) oxygen therapy in managing chronic obstructive pulmonary disease (COPD) patients complicated by respiratory failure.MethodsNinety-six patients with COPD and respiratory failure were enrolled and classified into a control group and an observation group. Both groups received conventional treatment. The control group was treated with AVAPS-mode NIV, while the observation group received additional HFNC. Clinical outcomes, adverse reactions, clinical indicators, blood gas parameters, serum inflammatory markers, and pulmonary function indicators were compared between the two groups.ResultsThe observation group had a significantly higher overall clinical response rate (93.75% vs 75.00%, <i>P</i> < 0.05), shorter ICU stays and mechanical ventilation times, lower respiratory rates, higher PaO₂, SaO₂, FEV₁, FVC, and FEV₁/FVC values, and lower PaCO₂, IL-6, IL-8, TNF-α, and sTREM-1 levels than the control group (all <i>P</i> < 0.05). Heart rate did not differ significantly between the two groups (<i>P</i> > 0.05). The adverse reaction rate was significantly lower in the observation group relative to the control group (4.17% vs 18.75%, <i>P</i> < 0.05).ConclusionThis combined approach demonstrates superior efficacy in treating COPD patients with respiratory failure, improving arterial blood gas and pulmonary function, reducing inflammatory responses, and exhibiting a high safety profile.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"845-852"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944464","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":"Do ICU Admissions Following Rapid Response Events Differ by Patient Demographics?","authors":"Shahla Siddiqui, Ryan Gould, Jennifer Stevens","doi":"10.1177/08850666251415523","DOIUrl":"10.1177/08850666251415523","url":null,"abstract":"<p><p>BackgroundRapid response systems (RRS) have been developed to identify and manage clinical deterioration on hospital floors. However, disparities in downstream care decisions, particularly ICU triage, remain poorly understood. This study investigated the role of demographic variables in ICU admission decisions following rapid response activation.MethodsWe conducted a retrospective analysis of 37,400 RRS activations at a tertiary academic medical center (2013-2023). Data included demographics, primary service at time of trigger trigger reasons, and code status. The RRS comprises an ICU nurse, respiratory therapist, and on-call ICU physician; however, the attending physician of record determines final disposition. Multivariable logistic regression estimated odds of ICU transfer, adjusted for age, sex, marital status, race, ethnicity, primary service, code status, and trigger reason; 95% CIs are reported.ResultsOf 13,799 patients, 1126 (8.2%) were transferred to the ICU after a trigger. Female sex was associated with 13.5% lower odds of ICU admission (OR 0.865; p < 0.05), and married status was associated with 18.6% higher odds of admission (OR 1.186; p < 0.05). Race and age were not significantly associated with ICU transfer. Interaction terms between race and activation reason were nonsignificant.ConclusionDespite similar clinical criteria for activation, female patients were less likely to be transferred to the ICU than male patients following a rapid response activation. This suggests a potential difference in acute care decision-making. Further research using a combination of prospective and mixed methods approaches would be beneficial to examine how healthcare providers make decisions and to explore strategies to reduce potential unintentional influences.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"874-882"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616076","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":"Prognosis of Patients with Lung Cancer Admitted to the Intensive Care Unit: A Systematic Review and Meta-Analysis.","authors":"Ahmed Elkhapery, Hazem Taifour, Chengu Niu, Ayman O Soubani","doi":"10.1177/08850666251339451","DOIUrl":"10.1177/08850666251339451","url":null,"abstract":"<p><p>IntroductionDespite recent advances in the care of critically ill patients with cancer, studies show that lung cancer is associated with higher Intensive Care Unit (ICU) mortality than other types of cancer. This systematic review and meta-analysis aim to investigate the ICU outcomes and predictors of mortality in critically ill patients with lung cancer.MethodsPubMed, OVID MEDLINE, Cochrane and Embase were searched to identify relevant studies. The primary outcome was ICU mortality. The secondary outcomes were hospital mortality and predictors of mortality. Abstracts, case reports and case series were excluded.ResultsThirty-three studies met inclusion criteria, including 28 cohort studies (n = 4123) and five population-based studies (n = 82,475). The pooled ICU mortality was 46.4% (95% CI 41.0-51.8; n = 16,772). The pooled hospital mortality was 51.9% (95% CI 46.9-56.9; n = 72,215). The pooled long-term mortality (6-12 months) was 73.5%, (95% CI 68.2- 78.2; n = 84,008). Predictors of mortality included the presence of metastatic disease (RR 1.30, 95% CI 1.06-1.59), poor performance status (RR 1.33, 95% CI 1.12-1.57), requirement for mechanical ventilation (RR 2.25, 95% CI 1.58-3.21), requirement for vasopressors (RR 1.95, 95% CI 1.54-2.46), higher APACHE or SAPS score (standardized mean difference 0.63, 95% CI 0.45-0.80), and higher SOFA score (mean difference 1.95, 95% CI 1.21-2.70).ConclusionCritically ill patients with lung cancer have reasonable short term but poor long-term outcome. Focused and early goals of care discussions are crucial part of ICU care in this patient population.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"814-829"},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078511","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":"Acute Severe Asthma in the Intensive Care Unit: From Bronchodilators to Extracorporeal Membrane Oxygenation.","authors":"Parisa Abedi, Geoffrey Chupp, Gabriella Wilson, Sandra Zaeh, Astha Chichra","doi":"10.1177/08850666261466238","DOIUrl":"https://doi.org/10.1177/08850666261466238","url":null,"abstract":"<p><p>Acute severe asthma exacerbations are life-threatening critical care emergencies characterized by profound airflow obstruction, respiratory acidosis, and risk for cardiopulmonary arrest. For the purposes of this review, the term 'acute severe asthma' is used to encompass what has variably been described as near-fatal asthma, status asthmaticus, and life-threatening asthma in the literature. Early recognition of impending respiratory failure, timely intubation and a stepwise approach to supportive interventions are critically important to minimize the risk of mortality and optimize outcomes. Initial treatment focuses on prompt initiation of medical therapies to stabilize ventilation and prevent progression to respiratory failure. If intubated, ventilatory strategies aimed at reducing dynamic hyperinflation and auto-PEEP with permissive hypercapnia need to be considered. When conventional management fails or when barotrauma risk, acid base derangements or hypoxemia become life-threatening, venovenous extracorporeal membrane oxygenation (VV-ECMO) can be utilized as a bridge to recovery. Given its invasiveness, careful patient selection for VV-ECMO is essential. This review provides an overview of: 1) the pathophysiology of acute severe asthma exacerbations, 2) expert guidelines and 3) consensus on best practices for the optimal use of standard and adjunctive pharmacologic treatments and mechanical ventilation strategies, and 4) patient selection criteria for and the emerging role of VV-ECMO for the treatment of acute severe asthma.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666261466238"},"PeriodicalIF":2.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840448","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":"Modern Approaches to the Treatment of Respiratory Distress Syndrome in Children: The Role of Surfactant and Antenatal Prophylaxis.","authors":"Aisuluu Omurzakova, Venera Azhikulova, Mairamkan Sharipova, Nargiza Kurbanova, Gulnura Zhunusbaeva","doi":"10.1177/08850666261454656","DOIUrl":"https://doi.org/10.1177/08850666261454656","url":null,"abstract":"<p><p>Background and ObjectiveThe aim of the study was to evaluate the multilevel impact of antenatal prophylaxis and modern non-invasive respiratory strategies on the course and outcomes of respiratory distress syndrome in new-borns.MethodsA total of 4080 hospitalisations of preterm and full-term infants with confirmed respiratory failure, born between 1 January 2017 and 30 September 2024, who received care at the Osh Regional Clinical Maternity Hospital (Kyrgyzstan), were included in the retrospective cohort registry. Gestational age, body weight, completeness of the antenatal glucocorticoid course, method of respiratory support, surfactant administration technique, incidence of bronchopulmonary dysplasia, and mortality were analysed.ResultsOver the observation period, the number of completed courses of betamethasone or dexamethasone increased from 120 to 442, and the proportion of early support with continuous positive airway pressure rose from 24% to 56%. In 2024, minimally invasive surfactant administration via thin catheter was applied in 70% of cases, which was accompanied by a reduction in the mean duration of mechanical ventilation from 68 ± 18 to 36 ± 12 h (p < 0.01) and a decrease in the incidence of bronchopulmonary dysplasia among infants weighing <1000 g from 42% to 26% (p = 0.03). Mortality within the first seven days of life declined from 21.7% to 11.4%, and the proportion of deaths within the first 24 h - from 30% to 12%. Among children who received a full antenatal course, the need for invasive ventilation amounted to only 6.8%, compared with 23.4% without prophylaxis (p < 0.001).ConclusionThe obtained data demonstrated the synergy of timely hormonal preparation and minimally invasive respiratory technologies, which made it possible to halve early neonatal mortality even in a resource-limited setting and laid the foundation for the introduction of a national protocol for managing respiratory distress syndrome in new-borns.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666261454656"},"PeriodicalIF":2.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840429","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":"Correlation Study Between Inflammatory Markers and Pathogenic Characteristics in Patients with Severe Pneumonia in Intensive Care Units.","authors":"Xiufang Lu, Yali Kang, Lin Liu, Jingping Liu, Qiuyue Zhang, Jinjing Tian, Chuntang Tong","doi":"10.1177/08850666261480632","DOIUrl":"https://doi.org/10.1177/08850666261480632","url":null,"abstract":"<p><p>ObjectiveTo determine pathogen-specific inflammatory biomarker profiles, develop predictive models for Gram-negative infections and evaluate the added value of serial biomarker monitoring in critically ill patients with severe pneumonia in intensive care units (ICUs).MethodsThis retrospective cohort study included 126 adults admitted to a tertiary ICU between 1 June 2021 and 31 May 2024. Procalcitonin (PCT), C-reactive protein (CRP) and interleukin-6 (IL-6) were measured at admission and on ICU days 3, 5 and 7. Biomarker-pathogen associations were assessed using Spearman correlation, receiver operating characteristic (ROC) analysis, multivariate regression and stratified analysis of polymicrobial infection and ICU secondary superinfection.ResultsPredominant pathogens were Acinetobacter baumannii (15.9%), Candida spp. (14.3%), Klebsiella pneumoniae (9.5%), Escherichia coli (7.1%), Pseudomonas aeruginosa (6.3%) and Staphylococcus aureus (3.2%). PCT and IL-6 correlated with Gram-negative infection, especially K. pneumoniae (PCT: r = 0.56, p < 0.001; IL-6: r = 0.51, p < 0.001). PCT ≥ 2.8 ng/mL predicted Gram-negative pneumonia with an AUC of 0.83 (95%CI: 0.78-0.88), 79% sensitivity and 74% specificity. Combining PCT>2.8 ng/mL with IL-6 > 95 pg/mL increased specificity to 87% in monomicrobial Gram-negative infection and 83% in polymicrobial cases. Sustained dual elevation over 72 h predicted 28-day ICU mortality (HR = 2.14, 95%CI: 1.32-3.47) and dynamic trends predicted secondary superinfection better than admission biomarkers (AUC: 0.81 vs 0.65). PCT and IL-6 did not distinguish multidrug-resistant from antimicrobial-susceptible K. pneumoniae.ConclusionPCT and IL-6 help identify Gram-negative pneumonia and serial monitoring adds prognostic value, but biomarker thresholds should be interpreted with clinical findings and microbiological susceptibility results.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666261480632"},"PeriodicalIF":2.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840375","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}