Journal of Obstetrics and Gynaecology最新文献

{"title":"Comparison of the efficacy of vaginal micronised progesterone tablet and gel for <i>in vitro</i> fertilisation.","authors":"Soo Jin Han, Hoon Kim, Yun Soo Hong, Sung Woo Kim, Seung-Yup Ku, Chang Suk Suh","doi":"10.1080/01443615.2024.2436518","DOIUrl":"https://doi.org/10.1080/01443615.2024.2436518","url":null,"abstract":"<p><strong>Background: </strong>Luteal phase support (LPS) with progesterone is a generally accepted practice after controlled ovarian stimulation, although the best protocols for LPS have been debated. We aimed to compare the efficacy of vaginal micronised progesterone tablets and 8% vaginal progesterone gel for LPS using real-world data.</p><p><strong>Methods: </strong>This retrospective study included 459 <i>in vitro</i> fertilisation/intracytoplasmic sperm injection cycles performed at a university hospital from 2005 to 2019. All cycles were followed by fresh day 3 embryo transfer (ET). Either progesterone tablets or gel was used for LPS. To control the conditional probability of progesterone tablets or gel use, doubly robust inverse probability weighting composed of inverse-probability-of-treatment weighting (IPTW) and regression adjustment (RA). IPTW was performed based on the covariate balancing propensity score (CBPS).</p><p><strong>Results: </strong>Progesterone tablets were administered in 65 cycles, and progesterone gel was administered in 394 cycles. Women who used progesterone tablets were more likely to be older (36 vs. 34 years), have primary infertility (78.5% vs. 61.4%), use gonadotropin-releasing hormone antagonist (60.0% vs. 43.2%), and have fewer retrieved oocytes (seven vs. nine) and transferred embryos (two vs. three) than participants who used progesterone gel. After IPTW-CBPS and RA analysis for the above covariates, the adjusted odds for clinical pregnancy in women who used progesterone tablets were 1.10 times compared with women who used progesterone gel; however, the 95% confidence interval did not reach statistical significance (0.96-1.26).</p><p><strong>Conclusions: </strong>Clinical pregnancy was comparable between vaginal micronised progesterone tablets and vaginal progesterone gel for LPS in fresh day 3 ET cycles.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2436518"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fertility preservation counselling and practice among women with lymphomas: a retrospective study.","authors":"Mariola Hernández Martínez, César Lizán Tudela, Blanca Carreras Gamón, Laura Gregori Navarro","doi":"10.1080/01443615.2025.2449679","DOIUrl":"https://doi.org/10.1080/01443615.2025.2449679","url":null,"abstract":"<p><strong>Background: </strong>Research on fertility preservation among women diagnosed with lymphoma is very limited. We aimed to assess the receipt of fertility preservation information and use of fertility preservation among women diagnosed with lymphoma.</p><p><strong>Methods: </strong>This was a retrospective, single-centre study. Patients with Hodgkin and non-Hodgkin lymphoma were screened from the electronic medical records of individuals who attended the Haematology Department at the study site between 2000 and 2018 and were followed-up for obstetric outcomes and onset of menopause until December 2023.</p><p><strong>Results: </strong>Forty-three patients had available electronic health records. Overall, 13 (36.1%) of the 36 patients ≤45 years old received fertility preservation counselling; it was more frequent among nulliparous women (11/23, 47.8%), women aged ≤35 years (11/26, 42.3%), and those diagnosed in the latest study period from 2015 to 2018 (9/16, 56.3%). Of the 13 patients who were informed about fertility preservation, 2 patients refused this intervention, and fertility preservation was contraindicated for 3 patients, leading to a total of eight women who underwent fertility preservation strategies: six underwent ovarian cortex cryopreservation, and two underwent oocyte vitrification. Among the participants aged ≤45 years, 10 (27.8%) had at least one live birth after diagnosis. Fifteen (34.9%) of the 43 participants exhibited amenorrhoea after the initiation of chemotherapy, including 4 women ≤35 years of age. The median (range) age at menopause in this series was 45 (27-50) years.</p><p><strong>Conclusion: </strong>Even though the situation appears to have improved in recent years, we are far from reaching the target of all women with lymphoma who are of reproductive age receiving fertility preservation counselling before initiating chemotherapy.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2449679"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of treatment failure of tubal pregnancy with single-dose methotrexate regimen - a systematic review and meta-analysis.","authors":"Lili Tang, Sipei Nie, Ling Ling, Qian Zhu","doi":"10.1080/01443615.2024.2447997","DOIUrl":"10.1080/01443615.2024.2447997","url":null,"abstract":"<p><strong>Background: </strong>Ectopic pregnancies represent a potentially life-threatening medical emergency, with 95% being tubal. This meta-analysis aimed to identify early predictors for single-dose methotrexate (MTX) treatment failure in tubal pregnancies.</p><p><strong>Methods: </strong>A literature search was conducted across several databases from their inception to December 2023, with references in the selected studies manually reviewed. 14 studies involving 2,804 patients were included in this meta-analysis.</p><p><strong>Results: </strong>The results revealed that higher serum beta-human chorionic gonadotropin (β-hCG) levels on Day 1 (SMD = 1.25, 95% CI 0.73-1.77), foetal cardiac activity presence (OR = 12.64, 95% CI 3.15-50.75), adnexal mass presence (OR = 4.66, 95% CI 2.02-10.74), yolk sac presence (OR = 5.35, 95% CI 2.33-12.27), thicker endometrium (MD = 1.74, 95% CI 0.30-3.19), more number of previous ectopic pregnancies (MD = 0.21, 95% CI 0.13-0.30), history of pelvic inflammatory disease (PID) (OR = 3.97, 95% CI 2.02-7.79), higher progesterone levels on Day 1 (SMD = 0.22, 95% CI 0.07-0.36), a higher 48-hour pre-treatment increment in serum β-hCG percentage (MD = 11.46, 95% CI 2.95-19.98), and a higher percentage of serum β-hCG change from Day 4 to Day 0/1 (SMD = 2.58, 95% CI 1.02-4.14) were early predictive factors for treatment failure of tubal pregnancy with the MTX single-dose regimen.</p><p><strong>Conclusions: </strong>This review clarifies early predictive factors for treatment failure with the MTX single-dose regimen in tubal pregnancies. High-risk tubal pregnancies likely to fail MTX monotherapy could be identified earlier, allowing for personalised intervention measures to be implemented at an early stage to prevent harm and improve treatment outcomes.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2447997"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of gonadotropin-releasing hormone antagonist (GnRH-ant) cessation on trigger day in a GnRH-ant protocol: a meta-analysis.","authors":"Xueying Li, Yafang Cao, Jinli Lin, Rui Cai, Linhao Zhang, Yao Liu","doi":"10.1080/01443615.2024.2444496","DOIUrl":"https://doi.org/10.1080/01443615.2024.2444496","url":null,"abstract":"<p><strong>Background: </strong>The gonadotropin-releasing hormone antagonist (GnRH-ant) protocol is associated with few oocytes retrieved, few mature oocytes and poor endometrial receptivity. Omission of GnRH-ants on trigger day seems unlikely to induce preovulation and may improve outcomes in the GnRH-ant protocol. This study aimed to systematically evaluate the effects of GnRH-ant cessation on trigger day on in vitro fertilisation outcomes following the GnRH-ant protocol.</p><p><strong>Methods: </strong>We searched PubMed, Ovid/MEDLINE, Wanfang, VIP, CNKI and ClinicalTrials.gov databases. The last search was conducted on 10 December 2023 in English or Chinese, without time limitations on the collection of studies from the databases. The references in these articles were manually searched. Randomised controlled trials (RCTs) and cohort studies aimed at assessing the effects of GnRH-ant cessation on trigger day using the GnRH-ant protocol were included. The eligible studies included at least one of the main outcomes: number of oocytes retrieved, proportion of mature oocytes, implantation rate or clinical pregnancy rate.</p><p><strong>Results: </strong>Three studies with 1449 cycles were included. Cessation of GnRH-ant on trigger day improved the proportion of mature oocytes (odds ratio [OR] = 1.26, 95% confidence interval [CI] = 1.09-1.45, <i>I</i>² = 0%) but did not affect the number of oocytes retrieved (mean difference [MD] = 0.50, 95% CI = -0.07 to 1.07, <i>I</i>² = 47%), implantation rate (OR = 0.95, 95% CI = 0.69-1.30, <i>I</i>² = 0%), clinical pregnancy rate (OR = 1.06, 95% CI = 0.71-1.58, <i>I</i>² = 0%), endometrial thickness (MD = -0.09, 95% CI = -0.27 to 0.10, <i>I</i>² = 0%) or cycle cancellation rate (OR = 0.64, 95% CI = 0.15-2.74, I² = 0%).</p><p><strong>Conclusions: </strong>Cessation of GnRH-ant on trigger day of the GnRH-ant protocol is suggested because it could improve the proportion of mature oocytes. However, further RCTs are required.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2444496"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of sterile normal saline and 1% povidone-iodine for vaginal preparation in vesicovaginal fistula: a randomised trial.","authors":"Xinyan Che, Mingjian Ruan, Yang Yang, Zhijun Xi, Yanbo Huang, Wei Wang, Lijun Zhong, Kaiyue Chen, Yuke Chen, Shiliang Wu","doi":"10.1080/01443615.2024.2439356","DOIUrl":"https://doi.org/10.1080/01443615.2024.2439356","url":null,"abstract":"<p><strong>Background: </strong>Vaginal preparation before transvaginal gynecological surgeries improves the success rate. However, there is no consensus on which agent is superior for transvaginal repair of vesicovaginal fistula (VVF). We aimed to compare irritation symptoms and antimicrobial function between sterile normal saline (SS) and 1% povidone-iodine (PI) for vaginal preparation in surgical repair of VVF.</p><p><strong>Methods: </strong>This randomised, controlled trial was conducted on patients with VVF underwent transvaginal repair. Preoperative vaginal irrigation was randomly performed with either SS or 1% PI. The patients' self-reported symptoms questionnaires, including numerical rating scale (NRS) of pain, Indevus urgency severity scale (IUSS), and vaginal symptoms, tissue edoema degree and pathogenic microbiology were recorded.</p><p><strong>Results: </strong>The study included 30 patients in the SS group and 31 patients in the PI group. After twice irrigations before surgery, compared with the PI group, the SS group had a similar count of bacterial species but a higher bacterial load (<i>p</i> = .079 and <i>p</i> = .033). The NRS of pain and IUSS in the SS group were lower than those in the PI group (<i>p</i> < .001). The SS group had less severe vaginal symptoms (<i>p</i> < .001) and tissue edoema (<i>p</i> < .001) than the PI group. The successful repair rates were 86.7% in the SS group and 83.9% in the PI group (<i>p</i> = .758). Patients with more severe urinary and vaginal symptoms had lower successful repair rates (92.3% vs. 72.7%, <i>p</i> = .047).</p><p><strong>Conclusions: </strong>SS is an effective vaginal preparation liquid for transvaginal repair of VVF with less irritation symptoms and acceptable antimicrobial function.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2439356"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing postpartum haemorrhage training by integrating case-problem based learning with simulation: a quasi-experimental study [Letter].","authors":"Sari Luthfiyah, Triwiyanto Triwiyanto, Mohammed Ismath","doi":"10.1080/01443615.2025.2472782","DOIUrl":"https://doi.org/10.1080/01443615.2025.2472782","url":null,"abstract":"","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2472782"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunohistochemical and bioinformatics analysis of the placental BCL-2 and Beclin-1 expressions in preeclampsia and HELLP syndrome.","authors":"Süleyman Cemil Oğlak, Fırat Aşır, Emine Zeynep Yılmaz, Ayşegül Aşır, Gökhan Bolluk, Tuğcan Korak, Hayat Ayaz, Elif Ağaçayak","doi":"10.1080/01443615.2025.2478577","DOIUrl":"https://doi.org/10.1080/01443615.2025.2478577","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to examine the alterations in apoptosis and autophagy in placental tissues from normal pregnancies compared to those affected by preeclampsia (PE) and HELLP (haemolysis, elevated liver enzymes, low platelets) syndrome. We analysed the expression of autophagy-associated proteins, Beclin-1 and BCL-2, in human placental tissues and assessed their variations in placentas from pregnancies complicated by PE and HELLP syndrome by immunohistochemical (IHC) and in silico analyses.</p><p><strong>Methods: </strong>An experimental case-control study was performed, involving 40 pregnant women complicated with preeclampsia, 25 pregnant women with HELLP syndrome, and 40 healthy pregnant women. The placental sections were stained with BCL-2 and Beclin-1 immunostains and subjected to IHC examination. The results of the IHC staining were assessed using semi-quantitative analysis. In silico analyses were performed using STRING and Cytoscape software to construct protein interaction networks for BCL-2 and Beclin-1 in PE and HELLP syndrome, followed by Gene Ontology analysis of common interactors to identify significant biological pathways.</p><p><strong>Results: </strong>Both BCL-2 expression was significantly decreased (<i>p</i> < 0.001 and <i>p</i> < 0.0001, respectively) and Beclin-1 staining was significantly increased (<i>p</i> < 0.0001 and <i>p</i> < 0.0001, respectively) in the PE group and HELLP group compared to the control group. The changes in BCL-2 and Beclin-1 expression between PE and the HELLP group were also statistically significant. BCL2 expression was notably lower (<i>p</i> < 0.0001), and Beclin-1 staining was significantly higher (<i>p</i> < 0.05) in the HELLP group compared to the PE group. In PE, BCL-2 interactors were enriched in apoptosis, cytokine production, and cell proliferation pathways, while Beclin-1 interactors were linked to autophagy and phosphatidylinositol-mediated signalling. In HELLP, BCL-2 interactors were involved in inflammatory response regulation, whereas Beclin-1 interactors were associated with vascular endothelial growth factor (VEGF) signalling and immune regulation.</p><p><strong>Conclusions: </strong>The differential expression patterns of BCL-2 and Beclin-1 between the PE and HELLP groups suggest that these proteins play distinct roles in the pathophysiology of these conditions.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2478577"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with a transabdominal cerclage due to recurrent mid-trimester losses are not at higher risk of foetal growth restriction: a retrospective study.","authors":"David R Hall, Lana Koster, Mari van de Vyver","doi":"10.1080/01443615.2025.2452839","DOIUrl":"https://doi.org/10.1080/01443615.2025.2452839","url":null,"abstract":"<p><p>Foetal growth restriction (FGR) is associated with neonatal morbidity, suboptimal neurodevelopmental outcomes and chronic diseases. Successful pregnancies of women with recurrent mid-trimester pregnancy losses may still be at risk of FGR and small for gestational age (SGA) outcomes. This study aimed to investigate whether patients with recurrent mid-trimester pregnancy losses who undergo transabdominal cerclage (TAC) are at an increased risk of FGR. Due to a paucity of information in this regard, and to inform accurate counselling, we performed a secondary analysis of a unique set of patients with a TAC procedure. Foetal growth restriction (<3rd centile) was present in 8% of cases, with more female than male babies falling in this category (9.2 vs. 7.4%). When combined, FGR plus SGA were present in 19.4% of cases. This rate is not higher than the expected population rate of around 20% in low- and middle-income countries.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2452839"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic strategies to prolong gestation in preterm preeclampsia.","authors":"Henrique Provinciatto, Edward Araujo Júnior, Roberta Granese","doi":"10.1080/01443615.2024.2442815","DOIUrl":"https://doi.org/10.1080/01443615.2024.2442815","url":null,"abstract":"","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2442815"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical outcomes after gender-affirming hysterectomies: a consecutive case series of 72 patients.","authors":"Susanna Alder, Kiriaki Papaikonomou, Leonora Tebani, Ilmatar Rooda, Cecilia Dhejne, Pauliina Damdimopoulou, Sebastian Gidlöf","doi":"10.1080/01443615.2025.2463419","DOIUrl":"https://doi.org/10.1080/01443615.2025.2463419","url":null,"abstract":"<p><strong>Background: </strong>Hysterectomy is a significant component of gender-affirming treatment for transgender individuals. The choice of surgical technique and associated complications have been studied, but very few studies have used a standardised classification system to grade surgical complications. This study aimed to describe our hospital's experience on gender-affirming hysterectomies with regards to patient demographics, surgical techniques, and postoperative complications using a validated classification system.</p><p><strong>Methods: </strong>The study is a prospective follow-up case-series study of 72 consecutive patients undergoing gender-affirming hysterectomy at Karolinska University Hospital between 2016 and 2023. Patient demographics (age and mean body mass index), tobacco and alcohol habits, medical history and comorbidities, route of hysterectomy, complications and 30-days postoperative outcomes were reported. Surgical complications were graded according to the Clavien-Dindo classification system.</p><p><strong>Results: </strong>The study population, with an average age of 27.6 years, presented diverse medical conditions, with psychiatric diagnoses being the most prevalent. The most common procedure was total laparoscopic hysterectomy, with low intraoperative blood loss. Surgical complications were rare, and primarily required minimal interventions. The 30-day Clavien-Dindo postoperative complication rate of grade II or higher was 19%, although only 4% experienced complications necessitating re-surgery (grade III or higher). Postoperative follow-up emerged as a critical aspect, with 22% of patients seeking non-elective medical attention within the first month, often due to vaginal bleeding or abdominal pain.</p><p><strong>Conclusions: </strong>Our findings support the safety and feasibility of gender-affirming hysterectomies, particularly when performed laparoscopically, with very few severe complications observed using a validated scoring system. Extensive follow-up care, as well as addressing common postoperative concerns, is essential. Despite a relatively small sample size and lack of a control group, this study provides valuable insights into transgender healthcare from a previously unstudied region. Future research should preferably include larger cohorts, multicentre and registry-based studies.</p>","PeriodicalId":16627,"journal":{"name":"Journal of Obstetrics and Gynaecology","volume":"45 1","pages":"2463419"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}