Journal of Pain Research最新文献

{"title":"Association Between Spinopelvic Alignment and Reoperation Following Percutaneous Transforaminal Endoscopic Decompression: A Matched Case-Control Study.","authors":"Yang Ge, Aobo Wang, He Song, Ning Fan, Lei Zang","doi":"10.2147/JPR.S505372","DOIUrl":"10.2147/JPR.S505372","url":null,"abstract":"<p><strong>Purpose: </strong>Percutaneous transforaminal endoscopic decompression (PTED) is widely used for treating lumbar spinal stenosis (LSS), yet predictors of reoperation remain unclear. This study aimed to explore the association between spinopelvic alignment and the reoperation following PTED.</p><p><strong>Patients and methods: </strong>A 1:2 matched case-control study was conducted, involving patients who underwent single-level PTED for LSS at our institution from May 2014 to August 2022. Cases comprised patients requiring reoperation after initial PTED, while controls were those without reoperation during the follow-up. Measured radiological parameters included pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), lumbar lordosis (LL), mismatch between pelvic incidence and lumbar lordosis (PI-LL), disc height (DH), Pfirrmann classification, and Modic changes (MCs). Univariate and multivariate logistic regression analyses were performed to identify predictors. Receiver operating characteristic (ROC) curves were generated to determine cut-off points.</p><p><strong>Results: </strong>76 cases and 152 controls were selected from 1967 enrolled patients. Both groups had an average age of 61 years, a male-to-female ratio of 43:33, and a mean BMI of 25.95 kg/m². No significant differences in baseline characteristics were found between groups. Multivariate analysis identified PT (OR = 1.061, P = 0.007), PI-LL (OR = 1.057, P = 0.021), and DH (OR = 1.194, P = 0.015) as independent risk factors for the reoperation. ROC analysis revealed PI-LL with an area under the curve (AUC) of 0.662 at a cut-off of 12.95° (95% CI = 0.582-0.741), PT with an AUC of 0.685 at a cut-off of 21.98° (95% CI = 0.606-0.763), and DH with an AUC of 0.602 at a cut-off of 8.22° (95% CI = 0.521-0.683).</p><p><strong>Conclusion: </strong>PI-LL ≥ 12.95°, PT ≥ 21.98°, and DH ≥ 8.22° are independent risk factors for reoperation following PTED.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"1351-1360"},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal Cord Stimulation Explantation and Chronic Pain: A Systematic Review and Technology Recommendations.","authors":"Sayed E Wahezi, Ugur Yener, Tahereh Naeimi, Joshua B Lewis, Sandeep Yerra, Philip Sgobba, Hatice Begum Ciftci, Amaresh Vydyanathan, Elisa Chiu, Denis Cherkalin, Jay Y Darji, Ryan Masterson, Danielle Lee, Atthakorn Jarusriwanna, Suwannika Palee, Nicole R Ortiz, Moorice Caparo, Eli Dayon, Camille Fontaine, Marom Bikson, Michael E Schatman, Scott G Pritzlaff, Timothy R Deer, Corey W Hunter","doi":"10.2147/JPR.S514732","DOIUrl":"10.2147/JPR.S514732","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain affects 20.5% of the US population, costing $296 billion annually in lost productivity. Spinal cord stimulation (SCS) has become a key treatment for refractory neuropathic and nociceptive pain, with increasing usage due to technological advancements. However, the durability of SCS therapy, including explantation rates, remains a concern. Understanding explantation causes is essential for improving patient selection and device effectiveness. This study aims to analyze SCS explantation rates and reasons, as well as evaluate the financial burden of these procedures on the healthcare system.</p><p><strong>Methods: </strong>Three primary screening methods were used: manual search with keywords, MeSH term query, and reference list screening. The search covered PubMed, Cochrane, and Web of Science databases from inception to November 2024, yielding 719 articles. After applying eligibility criteria, 72 articles were identified, and 25 were selected for analysis. Data extraction was done by independent reviewers, with a second reviewer ensuring accuracy. Discrepancies were resolved by the corresponding editor.</p><p><strong>Results: </strong>We reviewed data from 13,026 patients who underwent permanent SCS implantation between 1984 and 2024, across 25 studies. A total of 1882 patients (9.82%) underwent explantation. The most common reason was lack of efficacy and inadequate pain relief (38%), followed by lead failure (15%) and infection (14%). While SCS is generally effective, issues related to device longevity and patient satisfaction persist, with explantation rates due to technical failures and lack of efficacy being concerns.</p><p><strong>Conclusion: </strong>SCS efficacy varies, with explantation rates reaching up to 38%, often due to inadequate pain relief. Most explantations occur within the first year, despite SCS being a safe and effective treatment. High implantation costs ($35,000 to $70,000) and revision costs ($15,000 to $25,000) raise concerns among payors. The hardware-driven model limits waveform flexibility, highlighting the need for innovation.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"1327-1340"},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Poor Pain Control and Sensory Impairment: A Cross-Sectional Study.","authors":"Junjian Zeng, Zhiqiang Liao, Aiqing Lin, Yu Zou, Yixun Chen, Zhonghua Liu, Hongqing Luo, Zhidong Zhou","doi":"10.2147/JPR.S504303","DOIUrl":"10.2147/JPR.S504303","url":null,"abstract":"<p><strong>Purpose: </strong>Poor pain control may lead to persistent physical discomfort and even reduced perceptual abilities. This research seeks to investigate the relationship between pain status and duration and sensory impairments.</p><p><strong>Patients and methods: </strong>This study used data on pain and sensory impairments from the National Health and Nutrition Examination Survey (NHANES) conducted from 2011 to 2014, including 8043 participants. Functional status of vision, hearing, smell, and taste was gathered using structured questionnaires. Logistic regression models were used to evaluate the association between pain status, duration, and the total number of sensory impairments and specific sensory deficits, while adjusting for key covariates such as age, gender, BMI, and socioeconomic status. Stratified analysis was performed to determine factors that might confound this relationship.</p><p><strong>Results: </strong>The multivariable-adjusted regression model showed that individuals with pain for 1 to 3 years had a 64% increased risk of sensory impairment compared to those without pain (OR 1.640, 95% CI 1.132-2.376, <i>P</i> = 0.016), while those with pain for over 3 years had a 90.9% increased risk (OR 1.909, 95% CI 1.472-2.475, <i>P</i> = 0.001). We also found a statistically significant association between pain duration of ≥ 1 year and visual impairment (OR 1.841, 95% CI 1.252-2.705, <i>P</i> < 0.01). Furthermore, participants with pain duration > 3 years were significantly associated with olfactory impairment (OR 2.264, 95% CI 1.538-3.331, <i>P</i> < 0.001) and taste impairment (OR 2.070, 95% CI 1.335-3.209, <i>P</i> < 0.01). However, no statistically significant association was observed between pain duration and hearing impairment in any duration category.</p><p><strong>Conclusion: </strong>The results of this study suggest that individuals with longer chronic pain duration are at higher risk of sensory impairments, particularly visual, olfactory, and taste impairments. Timely and effective pain management may help reduce the risk of long-term sensory impairments.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"1313-1323"},"PeriodicalIF":2.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genicular Nerve Block as an Effective Treatment for Knee Pain: Addressing Variability and Enhancing Meta-Analysis Reliability [Letter].","authors":"Jia Liu, Chao Wen, Lichen Xu","doi":"10.2147/JPR.S523096","DOIUrl":"10.2147/JPR.S523096","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"1325-1326"},"PeriodicalIF":2.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Interscalene Brachial Plexus Block with Different Concentrations of Ropivacaine on Diaphragmatic Paralysis: A Randomized Controlled Study.","authors":"Ying Deng, Liwei Wang, Hua Zhang, Zhichao Xu, Ling Jiang, Yang Zhou","doi":"10.2147/JPR.S505238","DOIUrl":"10.2147/JPR.S505238","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the degree of diaphragmatic paralysis by assessing diaphragmatic excursion and pulmonary function following an ultrasound-guided interscalene brachial plexus block with two different concentrations of ropivacaine (0.2% and 0.5%).</p><p><strong>Methods: </strong>Forty patients undergoing shoulder arthroscopic surgery were randomly assigned to receive ultrasound-guided interscalene brachial plexus block with 20 mL of either 0.2% or 0.5% ropivacaine. Diaphragmatic excursion (DE) and diaphragm thickening fraction (TF) were measured using M-mode ultrasound before and 30 minutes after the block. Pulmonary function was assessed using a portable spirometer. Additional outcomes included pain scores and the occurrence of adverse effects.</p><p><strong>Results: </strong>DE was significantly reduced 30 minutes after block in the 0.5% group compared to the 0.2% group (p<0.01), as well as the TF (p<0.01). Forced vital capacity (FVC) was also significantly reduced in the 0.5% group 30 minutes after block in the preparation room compared to the 0.2% group (p<0.001). Both 0.2% and 0.5% ropivacaine had similar effects in improving postoperative pain. There were no serious block-related complications in either group.</p><p><strong>Conclusion: </strong>0.2% ropivacaine may impair pulmonary function less than 0.5% ropivacaine. The clinical significance of these differences requires further investigation.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"1341-1349"},"PeriodicalIF":2.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Commentary on \"Clinical Efficacy of Tuina Therapy for Acute Lumbar Sprain: A Bayesian Network Meta- Analysis Based on Randomized Controlled Trials\" [Response to Letter].","authors":"Jing Chen, Wu Li, Jiangshan Li","doi":"10.2147/JPR.S522148","DOIUrl":"https://doi.org/10.2147/JPR.S522148","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"1243-1245"},"PeriodicalIF":2.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11921790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cross-Sectional Study on Current Perioperative Pain Management and Nurses' Pain Management Self-Efficacy in China's Interventional Department.","authors":"Hao Zhang, Ya Meng, Xiaoxia Xu, Yanwei Li, Xue Li, Hongtao Hu, Lin Zheng, Xiaochun Hu","doi":"10.2147/JPR.S478935","DOIUrl":"10.2147/JPR.S478935","url":null,"abstract":"<p><strong>Objective: </strong>To critically evaluate the present status of perioperative pain management among nurses in interventional departments as well as to delineate the factors influencing the self-efficacy of pain management to provide a foundation for enhancing perioperative pain management practices.</p><p><strong>Methods: </strong>This was a descriptive cross-sectional study on 941 nurses from 24 Chinese provinces and municipalities. A questionnaire was conducted to examine the current pain management practices. Independent sample <i>t</i>-test and analysis of variance were used for inter-group comparison. Multiple linear regression analysis was done to analyze the influencing factors of pain management self-efficacy.</p><p><strong>Results: </strong>About 76.5% of the nurses in the interventional departments had undergone pain management training; however, more than one-third (37.6%) had not in the past two years. Merely 4.9% of nurses expressed confidence that their knowledge in pain management was sufficient to meet the demands the clinical practice. The foremost three areas of pain management information desired by the nurses in the intervention department were pain psychology (79.6%), pharmacological pain treatment (78.1%), and non-pharmacological pain interventions (77.4%). A majority (57.6%) of the nurses failed to assess the patients' comprehension and perspectives of analgesia, elements contributing to pain exacerbation or alleviation, and the outcomes of analgesic measures. The cumulative score for the pain self-efficacy questionnaire among nurses in the intervention department was 63.95±21.83. Multiple linear regression analysis revealed that variables such as the acquisition of pain knowledge, the frequency of pain training in the past two years, the ratio of evaluation tools employed for assessment, the prevalent utilization of multi-dimensional evaluation instruments, and professional course studies in academia were determinants influencing pain management self-efficacy.</p><p><strong>Conclusion: </strong>Perioperative pain management by interventional department nurses in China is unstandardized and lacks continuous education. Nursing administrators should create targeted training to boost pain assessment, prevention and treatment abilities.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"1291-1303"},"PeriodicalIF":2.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Use of Oral Celecoxib Preoperatively Reduces Risk of Delirium and Favors Functional Recovery in Elderly Patients with Femoral Neck Fracture: A Propensity Score-Matched Analysis\" [Letter].","authors":"Keyuan Fang, Shuyan Zhang, Xiaoxiao Ding","doi":"10.2147/JPR.S524682","DOIUrl":"10.2147/JPR.S524682","url":null,"abstract":"","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"1241-1242"},"PeriodicalIF":2.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of Infrared Thermography, Quantitative Sudomotor Axonal Reflex Testing, and 3-Phase Bone Scintigraphy for Complex Regional Pain Syndrome Diagnosis: A Retrospective Observational Study.","authors":"Chan Noh, Jiyong Lee, Hye Young Choi, Eunhye Park, Yong Sup Shin, Boohwi Hong, Youngkwon Ko, Chahyun Oh, Sun Yeul Lee","doi":"10.2147/JPR.S474451","DOIUrl":"10.2147/JPR.S474451","url":null,"abstract":"<p><strong>Purpose: </strong>Complex regional pain syndrome (CRPS) diagnosis poses challenges due to the absence of an objective and definitive test. Although laboratory tests such as infrared thermography, quantitative sudomotor axonal reflex testing (QSART), and 3-phase bone scintigraphy have been considered diagnostic aids, their use remains controversial. This retrospective study aimed to elucidate the diagnostic validity and potential value of these modalities for the diagnosis of CRPS.</p><p><strong>Patients and methods: </strong>The Budapest criteria were used to diagnose CRPS, and infrared thermography, QSART, and 3-phase bone scintigraphy were performed as ancillary tests. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis and measurement of sensitivity, specificity, and positive and negative likelihood ratios.</p><p><strong>Results: </strong>Of the 41 patients assessed, 26 (63.4%) were diagnosed with CRPS based on these criteria. Among the three tests, only infrared thermography demonstrated significant diagnostic performance (area under the ROC curve, 0.718; 95% confidence interval, 0.569-0.866; p = 0.003). Infrared thermography revealed a positive and negative likelihood ratio of 2.308 and 0.346, respectively, indicating clinically informative results. The three positive results exhibited the highest specificity (0.933) and positive predictive value (0.917).</p><p><strong>Conclusion: </strong>Among the three laboratory tests for CRPS, infrared thermography was the most useful. QSART and 3-phase bone scintigraphy did not show a significant diagnostic performance; however, combining the results of all three tests may provide additional diagnostic confidence in certain cases.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"1305-1312"},"PeriodicalIF":2.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evidence-Based Consensus for the Use of Neurostimulation for the Treatment of Non-Surgical Low Back Pain: The NEURON Group.","authors":"Timothy Ray Deer, Jason E Pope, Erika A Petersen, Rany T Abdallah, Kasra Amirdelfan, Nomen Azeem, Vishal Bansal, Kaku Barkoh, Kenneth B Chapman, Daniel R Denis, Michael J Dorsi, Alexander Escobar, Steven Michael Falowski, Rosa Amelia Garcia, Jonathan M Hagedorn, Robert D Heros, Whitney S James, Hemant Kalia, Todd Lansford, Mark N Malinowski, Suzanne Marie Manzi, Pankaj Mehta, Robert Z Moghim, Gregory Anthony Moore, Soriaya Lizette Motivala, Yeshvant A Navalgund, Raj G Patel, Julie G Pilitsis, Michael E Schatman, Philip Michael Shumsky, Natalie Holmes Strand, Nestor D Tomycz, James J Yue, Dawood Sayed","doi":"10.2147/JPR.S500342","DOIUrl":"10.2147/JPR.S500342","url":null,"abstract":"<p><strong>Introduction: </strong>The use of electrical neuromodulation has often been limited to those with previous back surgery, peripheral neuropathy, and complex regional pain syndrome. Many patients with severe intractable low back pain were thought to be candidates for spinal cord stimulation (SCS), dorsal root ganglion stimulation, or peripheral nerve stimulation but did not meet the criteria. Recently, additional high-level data has supported the use of SCS in non-surgical low back pain (NSLBP), and United States Food and Drug Administration approval has been granted. The American Society of Pain and Neuroscience (ASPN) executive committee realized an unmet need to develop criteria for patient selection for this specific patient population. This is a NEURON project (neuroscience, education, utilization, risk mitigation, optimal outcomes, and neuromodulation), a living guideline for evolving therapies and indications, and is focused on the use of neuraxial stimulation for the treatment of refractory pain.</p><p><strong>Methods: </strong>After board approval, the society accepted nominees for the project, with an emphasis on experience, publication, research, and diversity. The team created an outline for discussion, chose a grading system based on published guidelines, and created consensus points.</p><p><strong>Results: </strong>The evidence led to several consensus points to best guide patient selection based on the level of evidence and expert opinion. The results will lead to improved safety and efficacy in implanted patients, and to a new standard for best practices.</p><p><strong>Conclusion: </strong>The selection of patients for implantation in those who have NSLBP should be based on published literature, best practice, and expert opinion. This NEURON project will allow for regular updates to create a living guideline that will allow for better assimilation of information to improve safety and efficacy going forward.</p>","PeriodicalId":16661,"journal":{"name":"Journal of Pain Research","volume":"18 ","pages":"1247-1274"},"PeriodicalIF":2.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}