Journal of Perinatal Medicine最新文献

{"title":"Placental growth factor as a predictive marker of preeclampsia in twin pregnancy.","authors":"Guijie Qi, Ling Yao, Zhiming Liu, Wanru Guo, Heng Liu, Jinghua Zhang, Yulian He, Tiancong Jiang","doi":"10.1515/jpm-2024-0184","DOIUrl":"https://doi.org/10.1515/jpm-2024-0184","url":null,"abstract":"<p><strong>Objectives: </strong>Placental growth factor (PlGF) has been reported as a good biomaker for the prediction of preeclampsia occurring in the short term in singleton pregnancies, in women presenting with clinical suspicion of preeclampsia. This study aims to evaluate the predictive value of the PlGF in twin pregnancies.</p><p><strong>Methods: </strong>Twin pregnancies with clinically suspected preeclampsia (24 weeks 0 days-36 weeks 6 days of gestation) were enrolled in this study. The threshold of PlGF for predicting preeclampsia was determined on the basis of a receiver-operating characteristic curve to predict preeclampsia and the short-term occurrence of preeclampsia.</p><p><strong>Results: </strong>Within 1 week, 2 weeks, and 4 weeks of testing respectively, a cutoff value of 215 pg/mL for PlGF to predict preeclamsia in twin pregnancies suspected to have preeclampsia has a specificity of 100 %[51.7 %, 100 %], 100 %[62.9 %, 100 %], 93.8 %[667.6 %, 99.7 %], and a negative predictive value of 100 %[94.8 %, 100 %], 100 %[95.0 %, 100 %], and 98.9 %[93.0 %, 99.9 %].</p><p><strong>Conclusions: </strong>A cutoff value of 215 pg/mL for PlGF is a useful tool to exclude the development of preeclampsia within 4 weeks of measurement.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869346","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":"Impact of screening for large-for-gestational-age fetuses on maternal and neonatal outcomes: a prospective observational study.","authors":"Benjamin Birene, Alexandre Ferreira, Emilie Raimond, Olivier Graesslin, Uzma Ishaque, René Gabriel","doi":"10.1515/jpm-2024-0522","DOIUrl":"https://doi.org/10.1515/jpm-2024-0522","url":null,"abstract":"<p><strong>Objectives: </strong>Debates on the management of macrosomia are still current. We have to consider the consequences of screening to contribute to these discussions. Our aim is to study the consequences of the 3rd trimester fetal macrosomia screening protocols used in several centres in the same French region in order to determine whether this screening affects maternal and neonatal outcomes: mode of delivery, maternal complications (haemorrhage, perineal lesions), neonatal health (pH, Apgar score) and the occurrence of neonatal trauma during delivery.</p><p><strong>Methods: </strong>Prospective observational, multicenter cohort study (Reims, Châlons en Champagne and Charleville-Mézières hospitals). All women with low-risk pregnancies who could benefit from screening for fetal macrosomia were included. Neonatal macrosomia was defined as a weight above the 90th percentile according to AUDIPOG adjusted growth curves. The principal outcome was the cesarean section rate. Secondary outcomes were instrumental deliveries and maternal and neonatal morbidity and mortality.</p><p><strong>Results: </strong>2,217 women were included. Rates of cesarean section and instrumental delivery were higher if macrosomia had been screened, whether rightly, in large-for-gestational-age newborns (respectively 9,802 [1.638-190.290], p=0.038 and 3,021 [1.099-8.846], p=0.036) or wrongly, in newborns who were ultimately appropriate-for-date (respectively ORa 3.562 [1.377-10.128], p=0.01 and 3.042 [1.139-8.596], p=0.36). This screening did not reduce maternal and neonatal morbidity and mortality.</p><p><strong>Conclusions: </strong>Screening for fetal macrosomia may be associated with increased rates of cesarean section and instrumental delivery for large-for-gestational-age and appropriate-for-date newborns. These results do not show any impact of these variations on maternal or neonatal health, and do not allow us to change practices directly. They do, however, alert us to the consequences of widespread screening for LGA and its possible side effects, which could be better targeted to high-risk populations or improved according to other criteria.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846908","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":"Aberrant right subclavian artery: the importance of distinguishing between isolated and non-isolated cases in prenatal diagnosis and clinical management.","authors":"Claudia Montero Carreras, Berta Cortés Olivera, Raquel Saiz-Vivó, Queralt Ferrer Menduiña, Sandra Garcia Martínez, M A Rodríguez Pérez, Alberto Rodríguez Melcón, Pilar Prats Rodriguez","doi":"10.1515/jpm-2024-0398","DOIUrl":"https://doi.org/10.1515/jpm-2024-0398","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the association of aberrant right subclavian artery (ARSA) with genetic abnormalities and postnatal symptomatology, by comparing isolated and non-isolated ARSA cases.</p><p><strong>Methods: </strong>Retrospective, descriptive and comparative study involving fetuses diagnosed with ARSA during routine fetal ultrasound scans, between 19 and 40 weeks, in a tertiary referral university hospital in Barcelona from January 2007 to December 2023.</p><p><strong>Results: </strong>Out of 154 fetuses diagnosed with ARSA, 75.3 % (116) were classified as isolated cases, while 24.7 % (38) had associated structural anomalies. Non-invasive prenatal testing with cell-free DNA was performed in 27.3 % (42) of cases, yielding low-risk results in 96.6 %, with only one case of trisomy 21 detected. Genetic evaluation was pursued in 15.6 % (24) of cases, revealing abnormalities in three fetuses: one with trisomy 21 and two with 22q11 deletion. All affected fetuses had associated structural defects. Overall, 151 fetuses survived after birth, there were two terminations of pregnancy and one stillbirth. Mild symptoms at birth were observed in 1.9 % (3) of newborns, all from the non-isolated ARSA group.</p><p><strong>Conclusions: </strong>These findings emphasize the significance of distinguishing between isolated and non-isolated ARSA cases in prenatal diagnosis and clinical management, suggesting that isolated ARSA may be considered a normal vascular variation.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837206","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":"Exploring the safety and diagnostic utility of amniocentesis after 24 weeks of gestation: a retrospective analysis.","authors":"Tanisha Gupta, Vatsla Dadhwal, Anubhuti Rana, Madhulika Kabra, Neerja Gupta, Rashmi Shukla, K Aparna Sharma","doi":"10.1515/jpm-2024-0434","DOIUrl":"https://doi.org/10.1515/jpm-2024-0434","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to describe the indications, complications, yield, and safety of amniocentesis beyond 24 weeks for prenatal diagnostic procedures along with the associated maternal and fetal outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 60 pregnant women (with 61 fetuses) who underwent amniocentesis at or beyond 24 weeks from March 2021 to June 2023 at a tertiary care referral center. Data was collected from medical records and individual patient followups. Descriptive data was collected on patient demographics, amniocentesis indications, and the test results. The other outcomes analyzed were the procedure-related complications and pregnancy outcomes.</p><p><strong>Results: </strong>The mean gestational age at time of the procedure was 25^4/7 (24^1/7-33^1/7). The most common indication for late amniocentesis was abnormal sonographic findings (44/61, 72.13 %), with structural anomalies being the commonest (21/61, 34.44 %). There were no complications related to the procedure. Of the 60 women, 88.3 % (53/60) continued their pregnancies, while 11.66 % (7/60) opted for termination of pregnancy, and two patients had intrauterine fetal demise (2/61, 3.27 %). Genetic testing revealed abnormalities in 6.55 % (4/61) of cases. Of the 51 pregnancies, 39 delivered vaginally (76.47 %; 39/51) and 12 (23.52 %; 12/51) required caesarean sections. There were five neonatal and infant deaths due to heart defects (2), metabolic syndrome, congenital diaphragmatic hernia, and non-immune hydrops, respectively.</p><p><strong>Conclusions: </strong>Amniocentesis, done at a later gestation, is a safe and an effective tool for prenatal diagnosis and provides an opportunity to make a genetic diagnosis and further counseling.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818461","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":"Characteristics of the pregnancy and labour course in women who underwent COVID-19 during pregnancy.","authors":"Elvira Shukenova, Meile Minkauskiene, Nurzhamal Dzhardemalieva, Lyailya Koshenova, Saule Ospanova","doi":"10.1515/jpm-2024-0302","DOIUrl":"https://doi.org/10.1515/jpm-2024-0302","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to analyze the impact of COVID-19 on pregnancy and labor, focusing on its effects on maternal and child health. The research explores the relationships between coronavirus infection and clinical and laboratory parameters, as well as the risks of pregnancy complications and adverse birth outcomes.</p><p><strong>Methods: </strong>The study involved 60 pregnant women diagnosed with COVID-19. A comprehensive evaluation of clinical and laboratory indicators was conducted, employing correlation, regression, logistic analyses to determine risk factors.</p><p><strong>Results: </strong>There was a strong inverse correlation between carbon dioxide levels and haematocrit (-0.76), and a direct correlation between blood pH and partial pressure of oxygen (0.73). COVID-19 was associated with increased risks of preterm labor (OR=1.82), stillbirth (OR=2.11), pre-eclampsia (OR=1.46), and foetal distress. Multivariate analysis revealed a 200 g reduction in neonatal birth weight and higher risks of hospitalisation (OR=1.8), postpartum hemorrhage (OR=2.3), and preterm delivery (OR=2.5). Comorbid conditions such as cardiovascular abnormalities, diabetes, obesity, thrombophilias exacerbated the risks of complications, including pre-eclampsia, neonatal respiratory distress syndrome, venous thromboembolism.</p><p><strong>Conclusions: </strong>COVID-19 infection increases the likelihood of pregnancy complications and adverse outcomes, especially in women with comorbidities. These findings highlight the need for preventive strategies and risk management protocols for pregnant women during future outbreaks, emphasizing the importance of further research in this field.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791829","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":"Sex differences in lung function of adolescents or young adults born prematurely or of very low birth weight: a systematic review.","authors":"Eleanor Jeffreys, Allan Jenkinson, Oishi Sikdar, Grace Poole, Theodore Dassios, Anne Greenough","doi":"10.1515/jpm-2024-0411","DOIUrl":"https://doi.org/10.1515/jpm-2024-0411","url":null,"abstract":"<p><strong>Introduction: </strong>Prematurely born males compared to females have greater respiratory morbidiy in childhood, but differences in adolescents and young adults are less clear.</p><p><strong>Content: </strong>A systematic review was undertaken to determine if there were sex differences in the lung function of prematurely born or very low birth weight born adolescents and adults.</p><p><strong>Summary: </strong>Seven of 1969 studies were included (766 infants). Three found no significant differences, but did not give raw lung function data. Four studies reported lung function data by sex. One found no significant differences and another only reported results for females, which were not lower than the controls. Another found males compared to females aged 16-19 years had lung function z scores indicating a more obstructive pattern [p<0.05]. The males, however, had significantly better exercise tolerance. The fourth reported worse lung function only in preterm born adult males.</p><p><strong>Outlook: </strong>Male compared to female individuals born prematurely had worse lung function in adulthood, but only in two of seven studies, both reported results from patients born in the era of routine surfactant use. Further research is required to more robustly determine the effect of sex on lung function in adults born prematurely.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770040","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":"The association among fetal head position, fetal head rotation and descent during the progress of labor: a clinical study of an ultrasound-based longitudinal cohort study in nulliparous women.","authors":"Jing Fang, Wenwen Wang, Mo Liu, Ning Gu, Yimin Dai","doi":"10.1515/jpm-2024-0459","DOIUrl":"https://doi.org/10.1515/jpm-2024-0459","url":null,"abstract":"<p><strong>Objectives: </strong>To elucidate the effects of the timing of fetal head rotation on the labor progress and outcomes.</p><p><strong>Methods: </strong>A paired ultrasound measurement was performed at each of the three stages of labor: latency stage, active stage, and full-cervical-dilatation stage. The measurements included fetal head position, head-perineum distance (HPD) and the angle of progression (AOP).</p><p><strong>Results: </strong>A total of 46 pregnancy women were included and a total of 102 effective measurements were collected. The cases in occipital anterior position were all eutocia. The rate of cesarean section in the left transverse occipital group was the highest (15.7 %, 3/19). There were 13 cases (37.1 %) with fetal head rotation occur during active phase, changing from occipital transverse to anterior. Ten cases (28.6 %) rotated in the second stage of labor. The average rotation degree of occipital transverse to anterior position was 62.6°. When AoP <95°, 100 % of the women were occipital transverse; When AoP ≥125°, 66.7 % was occipital anterior. The rate of oxytocin utilization and epidural analgesia in the occipital posterior group was higher than that in the other groups (71.4 and 85.7 %, respectively).</p><p><strong>Conclusions: </strong>Occipital transverse is the most common fetal head position in the early stage of labor and fetal head rotation occurs mostly in the active phase and the second stage of labor. Sufficient time should be given in labor management for women that who tried vaginal delivery without contraindications.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770042","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":"Fetal hypoplastic left heart syndrome: key factors shaping prognosis.","authors":"Büşra Cambaztepe, Oya Demirci, Işıl Ayhan, Abdullah Alpınar, İlker K Yücel","doi":"10.1515/jpm-2024-0417","DOIUrl":"https://doi.org/10.1515/jpm-2024-0417","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of the study is to estimate factors affecting survival in prenatally diagnosed hypoplastic left heart syndrome (HLHS) and echocardiographic features predicting poor prognosis and early neonatal death.</p><p><strong>Methods: </strong>This study was designed as a retrospective cohort study. Cases of hypoplastic left heart syndrome diagnosed in the prenatal period between 2014 and 2023 were extracted from electronic medical records. Demographic data, echocardiographic features, results of genetic testing, pregnancy outcomes, and postnatal outcomes were analyzed.</p><p><strong>Results: </strong>Eighty-three prenatally diagnosed fetal HLHS cases were analyzed. Overall, survival during the study period was 26.5 %, and survival among live births was 35.4 %. Survival analysis has shown that the majority of deaths occurred during the neonatal period. Out of 62 live births, 47 had Norwood procedures, six had balloon procedures and three had hybrid procedures. Eleven out of 47 who had the Norwood procedures went on to have a Glenn operation, and only three had full Fontan palliation. The presence of additional extra-cardiac anomaly, need for extracorporeal membrane oxygenation (ECMO), bidirectional flow at pulmonary veins on color Doppler, and low birth weight are associated with survival and early neonatal death. Tricuspid regurgitation, restrictive foramen ovale, and fetal growth restriction (FGR) are not associated with survival. HLHS evolved from critical aortic stenosis has better survival rates.</p><p><strong>Conclusions: </strong>Extra-cardiac anomaly, need for ECMO, bidirectional flow at pulmonary veins, and low birth weight were negatively associated with survival and early neonatal death. The survival rate was higher among HLHS cases that had evolved from critical aortic stenosis.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770038","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":"Faculty retention in academic OB/GYN: comprehensive strategies and future directions.","authors":"Ivica Zalud","doi":"10.1515/jpm-2024-0513","DOIUrl":"https://doi.org/10.1515/jpm-2024-0513","url":null,"abstract":"<p><p>The retention of academic faculty, particularly in the field of Obstetrics and Gynecology (OB/GYN), has become a growing challenge in the post-COVID era. The healthcare landscape has been dramatically altered, leading to a \"Great Exit\" where a large number of faculty members are resigning or retiring early. This phenomenon is not just a financial burden as recruitment costs have skyrocketed, but also poses a threat to the stability and reputation of academic institutions. In this review article, we explore the underlying causes of faculty attrition, the predictors of resignation, and propose comprehensive strategies to retain talented faculty members. We highlight the importance of mentorship, career development opportunities, and fostering a supportive work environment that aligns with both institutional and individual values. The goal is to create a sustainable framework for faculty engagement that strengthens the academic mission and improves clinical outcomes.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770036","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":"Sonographic visualization and measurement of the fetal optic chiasm and optic tract and association with the cavum septum pellucidum.","authors":"Sevim Tuncer Can, Hakan Golbasi, Burak Bayraktar, Ceren Saglam, Ibrahim Omeroglu, Raziye Torun, Ilker Ucar, Ilknur Gumus Toka, Atalay Ekin","doi":"10.1515/jpm-2024-0393","DOIUrl":"https://doi.org/10.1515/jpm-2024-0393","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the sonographic visualization of the fetal optic chiasm (OC) and optic tracts (OTs), establish mid-trimester reference values, and assess the relationship between OC and OT dimensions and cavum septum pellucidum (CSP) measurements.</p><p><strong>Methods: </strong>This prospective cross-sectional study included 154 morphologically normal fetuses between 19 and 23 weeks of gestation. The diameters of the fetal OC and OTs were measured using two-dimensional transabdominal ultrasound in a transventricular axial section angled approximately 20-40° caudally. CSP length as well as anterior, middle, and posterior widths were measured by placing the cursor on the inner surfaces in the transventricular section. The average CSP width was included in the analysis.</p><p><strong>Results: </strong>The OC and OTs were successfully visualized in 109 fetuses and included in the analysis. Visualization success in transabdominal axial sections at 19-23 weeks was 70.8 %, with high intraobserver and interobserver reproducibility. Additionally, visualization rates were higher in advanced gestational weeks and in fetuses with breech presentation (p=0.007 and p=0.017, respectively). OC and OT dimensions were positively correlated with CSP length and width, biparietal diameter (BPD), head circumference (HC), and gestational age (p<0.05, for all).</p><p><strong>Conclusions: </strong>The OC and OTs were successfully visualized transabdominally in axial sections with high intraobserver and interobserver reproducibility. Additionally, OC and OT dimensions were positively correlated with gestational age, as well as with BPD, HC, and CSP measurements.</p>","PeriodicalId":16704,"journal":{"name":"Journal of Perinatal Medicine","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755206","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}