Journal of Neurological Surgery Part B: Skull Base最新文献

{"title":"Reconstruction of Clival Defects using Vascularized Free and Pedicled Flaps: Systematic Review and Proposed Algorithms.","authors":"Nitish Kumar, Brent A Chang, Michael J Marino, Amar Miglani, Lisa A Marks, Pedro Lança Gomes, Devyani Lal","doi":"10.1055/a-2576-7289","DOIUrl":"10.1055/a-2576-7289","url":null,"abstract":"<p><strong>Background: </strong>Reconstruction of clival defects may be challenging in expanded endonasal skull base surgery. We conducted a systematic review to evaluate the outcomes of vascularized flaps used for clival reconstruction.</p><p><strong>Methodology: </strong>The following databases were searched using a combination of Medical Subject Headings (MeSH) and keywords related to clival reconstruction in July 2024: Ovid Medline, Ovid Embase, Scopus, and Web of Science. Studies reporting outcomes of clival reconstruction with vascularized free and pedicled flaps in patients were selected for complete review.</p><p><strong>Results: </strong>Twenty-three studies were included for detailed study. Clival reconstruction with free flaps was done in 18 patients; 17 had a successful repair, outcome was not reported for 1. Facial vessels were preferred for microvascular anastomosis. Radial artery forearm flap and anterolateral thigh flap were most utilized. Pedicled flaps were used in 68 patients, with reported success in 85.3%. Nasoseptal flap was the most common intranasal flap, used in 34 patients with successful reconstruction in 85.3%. Temporoparietal fascia flap was the most common extranasal flap, successfully used in 13 patients. Intranasal pedicled flaps, wherever available, were preferably used for primary reconstruction; extranasal flaps were the next choice. Free flaps were reserved for salvage reconstruction due to prior failed or unavailable local pedicled flaps.</p><p><strong>Conclusion: </strong>Satisfactory reconstructive outcomes are reported using pedicled and free flaps. The flap of choice is determined by the previous surgical history, radiotherapy, wound vascularity, defect size, overall health of the surrounding nasal mucosa, simultaneous clival surgery, and the preferred pedicle transposition route (free flaps).</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"165-172"},"PeriodicalIF":0.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical Insights of the Internal Carotid Artery Dural Rings: Endonasal and Transorbital Comparative Perspective.","authors":"Roberto Manfrellotti, Alejandra Mosteiro, Dario Gagliano, Lorena Gómez López, Nikolay Lasunin, Doriam Perera Valdivia, Carlo Giorgio Giussani, Giorgio Giovanni Carrabba, Ramon Torné, Alberto Prats-Galino, Alberto Di Somma, Joaquim Enseñat","doi":"10.1055/a-2565-8881","DOIUrl":"10.1055/a-2565-8881","url":null,"abstract":"<p><strong>Background: </strong>The clinoidal segment of the internal carotid artery (ICA) is a complex transition zone between the intracavernous and intradural spaces. It is bordered by the distal dural ring (DDR), proximal dural ring (PDR), and anterior clinoid process (ACP). This study provides an endoscopic anatomical analysis of the clinoidal region using the endonasal endoscopic approach (EEA) and endoscopic transorbital approach (ETOA).</p><p><strong>Methods: </strong>Ten cadaveric head specimens were dissected at the Laboratory of Surgical Neuroanatomy of the University of Barcelona.</p><p><strong>Results: </strong>EEA exposes the medial clinoidal region, revealing the connection between the PDR and parasellar ligaments, although their individual components remain indistinct. ACP removal clarifies the relationship between DDR, the falciform ligament, and the diaphragma sellae. ETOA provides access to the outer clinoidal region, isolating PDR and DDR and detailing their continuity with adjacent ligaments.</p><p><strong>Conclusion: </strong>EEA and ETOA offer comprehensive insights into the clinoidal region's anatomy.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"207-217"},"PeriodicalIF":0.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Transnasal Approach for Deep Lateral Orbital Decompression: A Cadaver Study.","authors":"Teppei Takeda, Yasine Mirmozaffari, Asha Nadabar, Jackson R Vuncannon, Jared Martin, Adam J Kimple, Brent A Senior, Kazuhiro Omura, Nobuyoshi Otori, Charles Ebert, Christine Klatt-Cromwell, Brian D Thorp","doi":"10.1055/a-2565-9056","DOIUrl":"10.1055/a-2565-9056","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates the anatomical feasibility of an endoscopic transnasal approach for deep lateral orbital decompression using cadaver models.</p><p><strong>Design: </strong>Cadaver study.</p><p><strong>Participants: </strong>Four fresh frozen cadaver heads (eight sides) were used.</p><p><strong>Main outcome measures: </strong>Measurements of the sphenoid trigone before and after bone removal were assessed using CT scans. Key outcome measures included the width, height, depth, and volume of the trigone.</p><p><strong>Results: </strong>The transnasal approach achieved a 53.9% reduction in trigone volume, with significant decreases in height (65.0%), width (84.3%), and depth (76.8%). Preoperative measurements revealed an average orbital surface width of 20.0 mm, later reduced to 16.7 mm postoperatively. The average trigone depth was reduced from 16.1 to 12.0 mm, and height decreased from 21.3 to 13.4 mm in the postoperative assessment. The procedure showed a mild limitation in reduction along the cephalocaudal axis, with residual regions measuring 4.5 and 3.0 mm in the superior and inferior directions, respectively.</p><p><strong>Conclusion: </strong>The endoscopic transnasal approach effectively reduces the size of the sphenoid trigone, providing a promising alternative for orbital decompression with potential clinical applications. Future research should explore long-term outcomes and integration into surgical practice.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"218-224"},"PeriodicalIF":0.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter- and Intrarater Reliability of the Manjila and Semaan Classification System when Assessing Jugular Bulb Position.","authors":"Michelle L Hunt, Carson K Smith, Austin Svec, Alisha N Vaidya, Eric M Christiansen, John P Karis, Jeremy N Hughes","doi":"10.1055/a-2565-9000","DOIUrl":"10.1055/a-2565-9000","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates the inter- and intrarater reliability of the Manjila and Semaan classification system for the anatomical position of the jugular bulb. The classification system, proposed in 2018, aims to address inconsistencies in reporting that impact communication between radiologists and skull base surgeons and affect surgical planning.</p><p><strong>Design: </strong>Bilateral jugular bulb positions on 50 consecutive computed tomography (CT) venography examinations were assessed by two neuroradiology attending physicians, two neuroradiology fellows, and two radiology residents.</p><p><strong>Setting: </strong>The study was conducted in a clinical radiology setting on an Ambra PACS workstation.</p><p><strong>Participants: </strong>Consecutive patients who underwent clinical CT venography examinations between August 3, 2021, and January 29, 2022, and met the inclusion criteria were included in the analysis.</p><p><strong>Main outcome measures: </strong>Inter- and intrarater reliability were assessed using kappa values, Kendall's coefficient of concordance ( <i>W</i> ), and Spearman's rho.</p><p><strong>Results: </strong>Interrater agreement, measured by kappa values, showed moderate to substantial agreement for bilateral jugular bulb position types. Kendall's <i>W</i> indicated substantial to almost-perfect interrater agreement. Intrarater agreement was almost perfect according to kappa values and was high in monotonicity, as indicated by Spearman's rho.</p><p><strong>Conclusion: </strong>The Manjila and Semaan classification system demonstrated high inter- and intrarater reliability across a spectrum of experience levels. Adopting this classification could enhance clinical communication and improve surgical planning.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"e52-e58"},"PeriodicalIF":0.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Transorbital Approach for Select Recurrent and Newly Diagnosed Anteromedial Temporal Lobe Gliomas.","authors":"Jonathan A Tangsrivimol, Nader Delavari, Kyle J Godfrey, Theodore H Schwartz","doi":"10.1055/a-2561-7751","DOIUrl":"10.1055/a-2561-7751","url":null,"abstract":"<p><strong>Background and objective: </strong>The endoscopic lateral transorbital approach (eLTOA) has emerged as a minimal access technique for accessing the middle fossa and periorbital region. This study explores the applicability of eLTOA in the management of recurrent and newly diagnosed medial temporal lobe gliomas.</p><p><strong>Methods: </strong>Forty patients at our institution underwent eLTOA between 2016 and 2024. There were five surgeries for glioma. Patients were assessed for demographic and clinical data, radiographic characteristics, and histopathological and molecular findings.</p><p><strong>Results: </strong>Four recurrent gliomas required biopsy for diagnosis and molecular genotyping, and one newly diagnosed tumor aimed for gross total resection (GTR). Histologic diagnoses remained unchanged in three recurrent cases (two glioblastoma multiforme and one xanthoastrocytoma). One case was upgraded from oligoastrocytoma Grade II to glioblastoma Grade IV. GTR was achieved in the newly diagnosed tumor, with histology confirming dysembryoplastic neuroepithelial tumor. Average length of stay was 3 days. There was one case of transient diplopia.</p><p><strong>Conclusion: </strong>eLTOA offers a minimally invasive, direct approach to medial temporal lobe gliomas that minimizes the risks of infection and temporalis muscle atrophy associated with reoperation through a previously irradiated incision. It is most useful for restaging recurrent tumors, although GTR can be obtained in well-selected newly diagnosed tumors.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"200-206"},"PeriodicalIF":0.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vestibular Schwannomas in Pregnancy: A Case Series.","authors":"Jie Lily Huang, Hesham Khalid, Robert Chessman, Veronica Barnes, Andrew J Martin, Parag M Patel","doi":"10.1055/a-2561-7655","DOIUrl":"10.1055/a-2561-7655","url":null,"abstract":"<p><strong>Objectives: </strong>Vestibular schwannomas (VS) are benign intracranial tumors, the majority of which are indolent and managed conservatively with active surveillance. VS during pregnancy is rare and poorly understood. It is unclear whether hormonal changes during pregnancy contribute to VS growth. Currently, the largest case series describing VS during pregnancy comprises six cases from the Mayo Clinic in 1993, where they note that tumors tend to be larger and associated with higher surgical morbidity. We present five further cases of peripartum VS and their management strategies.</p><p><strong>Design: </strong>A retrospective review of 540 consecutive patients with sporadic VS at St George's Hospital from 2017 to 2023 was performed.</p><p><strong>Setting: </strong>St George's Hospital is a tertiary hospital in London providing joint neurosurgical and ENT management of VS.</p><p><strong>Participants: </strong>A total of 280 out of 540 patients were female (52%), and 5 were either pregnant at presentation or had given birth within 6 months of presentation (1%).</p><p><strong>Main outcome measures: </strong>Maternal/infant well-being, postoperative complications, and facial nerve function were our main outcome measures.</p><p><strong>Results: </strong>All patients had tumors >30 mm requiring translabyrinthine resection. One underwent VS resection with intraoperative lactation breaks 1 week following elective cesarean section. Two required cerebrospinal fluid (CSF) shunts to delay resection. One had her resection while 21 weeks pregnant. All had intact postoperative facial nerve function and healthy babies. One experienced a CSF leak requiring a lumbar drain.</p><p><strong>Conclusion: </strong>Because pregnancy tends to be associated with large tumors and surgery is complicated by obstetric considerations, appropriate counselling should be given to women of childbearing age.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"131-136"},"PeriodicalIF":0.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pitfalls in Trigeminal Nerve Mapping in Neurosurgery: The Mystery of the Unexpected Motor Responses.","authors":"Jose David Siado Mosquera, Ana Mirallave Pescador, Alba Diaz Baamonde, Jonathan Shapey, Sian Ebony Murace, Emily Clare Lawson, Arjel Lejarde, Sinan Barazi","doi":"10.1055/a-2561-7866","DOIUrl":"10.1055/a-2561-7866","url":null,"abstract":"<p><strong>Objective: </strong>Intraoperative neurophysiological mapping can help identify the trigeminal nerve (TN) during surgeries where it is at risk. Low-stimulating currents may only recruit sensory branch stimulation and trigger reflex responses, potentially complicating interpretation during monitoring. This report aims to address this issue by examining cases to categorize TN responses in relation to varying stimulation intensities, identify stimulation patterns, and clarify common response characteristics in surgical contexts.</p><p><strong>Methods: </strong>Seven cerebellopontine (CP) angle surgery cases with TN exposure were studied. Concentric bipolar stimulation was applied over the TN from 0.05 to 4 mA, and responses were recorded from various muscles innervated by the cranial nerves under monitoring (V, VII, IX, X, XI, XII).</p><p><strong>Results: </strong>Low stimulation currents (particularly below 0.5 mA) may elicit reflex responses over hypoglossal and facial innervated muscles, more often than motor responses, when the TN is stimulated.</p><p><strong>Conclusion: </strong>A stimulation protocol starting at 0.05 mA and increasing to at least 1 mA or until compound muscle action potentials are observed in trigeminally innervated muscles is recommended for accurate TN mapping in CP angle surgery. These results may be helpful to avoid misinterpreting reflex responses in non-TN-innervated muscles.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 2","pages":"137-143"},"PeriodicalIF":0.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12971223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Presentation Abstract of the North American Skull Base Society.","authors":"","doi":"10.1055/s-0045-1806731","DOIUrl":"10.1055/s-0045-1806731","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/s-015-61030.][This corrects the article DOI: 10.1055/s-0045-1803328.][This corrects the article DOI: 10.1055/s-0045-1803567.][This corrects the article DOI: 10.1055/s-0045-1803688.][This corrects the article DOI: 10.1055/s-0045-1803219.][This corrects the article DOI: 10.1055/s-0045-1803252.].</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"86 Suppl 1","pages":"e2"},"PeriodicalIF":0.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11945205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"June 4: International Skull Base Surgery Day.","authors":"David A Gudis, Benjamin S Bleier, Jean Anderson Eloy, James J Evans, Juan Carlos Fernandez-Miranda, Paul A Gardner, Mathew Geltzeiler, Jessica W Grayson, Richard J Harvey, Elisa A Illing, David W Kennedy, Cristine Klatt-Cromwell, Edward C Kuan, Jivianne Lee, Michael J Link, James K Liu, Patricia Loftus, Nyall R London, Erin L McKean, Kibwei A McKinney, L Madison Michael, Gurston G Nyquist, Zara M Patel, Mindy Rabinowitz, Sanjeet V Rangarajan, Kenneth D Rodriguez, Nicholas R Rowan, Rodney J Schlosser, Kafui Searyoh, Raymond F Sekula, Timothy L Smith, Carl Snyderman, Satyan B Sreenath, Dennis M Tang, Brian D Thorp, Eric W Wang, Marilene B Wang, Bradford A Woodworth, Garret Choby","doi":"10.1055/a-2538-4080","DOIUrl":"10.1055/a-2538-4080","url":null,"abstract":"","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"86 3","pages":"243-244"},"PeriodicalIF":0.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-Institutional Modified Delphi For Genomics in Expert Consensus Survey of Genomic Testing for Anterior Skull Base Malignancies.","authors":"Anirudh Saraswathula, Shreya Sriram, Corinna Levine, Nyall R London, Shirley Y Su, Mathew Geltzeiler, Sanjeet V Rangarajan, Ian Witterick, Brian Thorp, Kathleen Kelly Gallagher, Kenneth Byrd, Ricardo Carrau, Waleed Abuzeid, Eric Wang, Carl Snyderman, Erin L McKean","doi":"10.1055/a-2531-2230","DOIUrl":"10.1055/a-2531-2230","url":null,"abstract":"<p><strong>Objectives: </strong>The use of genomic testing for patients with anterior skull base malignancies has grown dramatically. There are no clear guidelines on indications for testing. As the literature on the subject is still in early stages, there is a need for expert consensus. We conducted a modified Delphi expert consensus process with high-volume North American cranial base surgical programs.</p><p><strong>Design setting participants: </strong>A modified Delphi consensus approach was used, following the method laid out by the American Academy of Otolaryngology-Head and Neck Surgery, and included 13 high-volume care centers. An otolaryngologist was appointed at each location to serve as the institutional representative.</p><p><strong>Main outcome measures: </strong>Participant responses to Delphi surveys were tabulated to determine consensus.</p><p><strong>Results: </strong>Thirteen teams responded comprising 23 otolaryngologists and 10 neurosurgeons. Overall, 11 of 12 institutions reported genomic testing to be fairly or easily available at their location, and 22 of 38 initial statements achieved consensus. Statements achieving consensus focused on primary and recurrent rare tumors without possibility of margin-negative resection, those with family history of anterior skull base malignancies, or rare tumors with distant metastasis. Statements regarding routine genomic sequencing or for primary tumors and cost of care did not achieve consensus.</p><p><strong>Conclusion: </strong>Expert multidisciplinary teams agreed on several appropriate settings for genomic sequencing in patients with anterior skull base malignancies, including recurrence, distant metastasis, and the inability to achieve a margin-negative resection. Further research is needed to explicitly clarify the role of genomic sequencing in this rare disease group.</p>","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":"87 1","pages":"14-22"},"PeriodicalIF":0.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12774504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}