Journal of pediatric surgery最新文献

{"title":"Serum Lactate Clearance as a Predictive Biomarker for Optimal Graft Perfusion in Living Donor Liver Transplantation","authors":"Keisuke Kajihara,&nbsp;Toshiharu Matsuura,&nbsp;Yasuyuki Uchida,&nbsp;Maeda Shohei,&nbsp;Yukihiro Toriigahara,&nbsp;Yoshiaki Takahashi,&nbsp;Tatsuro Tajiri","doi":"10.1016/j.jpedsurg.2024.07.032","DOIUrl":"10.1016/j.jpedsurg.2024.07.032","url":null,"abstract":"<div><h3>Background</h3><div>The optimal balance between the graft volume (GV) and portal venous flow (PVF) in living donor liver transplantation (LDLT) is unclear. As lactate is mainly metabolized in the liver, perioperative lactate levels are reportedly a useful biomarker for early graft dysfunction (EGD). The present study analyzed perioperative lactate levels according to the PVF.</div></div><div><h3>Methods</h3><div>The PVF/GV (mL/min per 100 g GV) of 97 recipients from 1996 to 2022 was retrospectively classified as low (LPVF; PVF/GV ≤ 100, N = 29), moderate (MPVF; PVF/GV 100–250, N = 40), or high (HPVF; PVF/GV &gt; 250, N = 28). Lactate levels were obtained preoperatively (L0), immediately after graft reperfusion (L1), 4 h after reperfusion (L2), and on postoperative day 3 (L3). The lactate clearances were then calculated.</div></div><div><h3>Results</h3><div>The lower the PVF/GV ratio, the younger the age at LDLT and the higher the graft-to-recipient weight ratio. The median L2 and L3 in the HPVF group were significantly higher than those in the other groups (p = 0.019 and p = 0.003, respectively). The median ΔL1 in the HPVF group was lower than that in the LPVF and MPVF groups (0.23 vs. 0.50, p &lt; 0.0001 and 0.23 vs. 0.41, p = 0.011, respectively). ΔL1 was negatively correlated with the PVF/GV. Although no patient had EGD, three patients with HPVF with low ΔL1 developed small-for-size syndrome.</div></div><div><h3>Conclusions</h3><div>Graft hyperperfusion may delay the recovery of the graft function and result in poor lactate clearance. The combination of the PVF/GV and lactate clearance may be useful as a prognostic marker for optimal graft perfusion in LDLT.</div></div><div><h3>Level of evidence</h3><div>IV.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 2","pages":"Article 161647"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141841380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Intestinal Perforation by Daily Radiographic Findings in Very Low Birth Weight Infants With Meconium Ileus","authors":"Yoshio Katsumata ,&nbsp;Keita Terui ,&nbsp;Ayako Takenouchi ,&nbsp;Shugo Komatsu ,&nbsp;Yunosuke Kawaguchi ,&nbsp;Katsuhiro Nishimura ,&nbsp;Naoko Mise ,&nbsp;Gen Matsuura ,&nbsp;Mamiko Endo ,&nbsp;Yoshiteru Osone ,&nbsp;Yuko Sonoda ,&nbsp;Kazushi Yoshida ,&nbsp;Tomoro Hishiki","doi":"10.1016/j.jpedsurg.2024.162076","DOIUrl":"10.1016/j.jpedsurg.2024.162076","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to develop a prediction model for intestinal perforation from meconium ileus (MI) based on findings from plain X-ray images.</div></div><div><h3>Methods</h3><div>Very low birth weight (VLBW) infants with MI hospitalized in two tertiary centers between 2011 and 2022 were included in this study. We retrospectively reviewed clinical parameters and assessed plain X-ray images from 0 to 5 days of age. The standardized transverse diameter of intestinal gas (STDI) was calculated by dividing the largest diameter of the intestinal gas by the distance from the upper edge of L1 to the lower edge of L4. We then compared the STDI of patients with and without intestinal perforation.</div></div><div><h3>Results</h3><div>Among 81 VLBW infants with MI, intestinal perforation occurred in 6 (7 %). Among known risk factors, significant differences were observed between the two groups regarding pregnancy-induced hypertension (<em>p</em> = 0.03), weeks of gestation (<em>p</em> &lt; 0.01), birthweight (<em>p</em> = 0.02), and indomethacin administration (<em>p</em> &lt; 0.01). The mortality rate was higher in the perforation group (33 %) than in the non-perforation group (3 %) (<em>p</em> = 0.021). There were significant differences between the perforated and non-perforated groups regarding STDI except at 0 days of age. The positive and negative predictive cut-off values of STDI were respectively 0.08 and 0.93 on day 0, 0.30 and 1.00 on day 1, 0.33 and 0.97 on day 2, 0.33 and 1.00 on day 3, 0.29 and 1.00 on day 4, and 0.33 and 0.98 on day 5, respectively.</div></div><div><h3>Conclusions</h3><div>Our novel prediction model, using STDI, predicted intestinal perforation in VLBW infants with MI.</div></div><div><h3>Levels of Evidence</h3><div>Level Ⅲ</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 2","pages":"Article 162076"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Initiation of Statewide Pediatric Trauma Collaborative and Hospital Preventable Transfer Rates","authors":"Jack H. Scaife ,&nbsp;Christopher E. Clinker ,&nbsp;Abigail J. Alexander ,&nbsp;Stephanie E. Iantorno ,&nbsp;R. Scott Eldredge ,&nbsp;Robert A. Swendiman ,&nbsp;Stephen J. Fenton ,&nbsp;Katie W. Russell","doi":"10.1016/j.jpedsurg.2024.162004","DOIUrl":"10.1016/j.jpedsurg.2024.162004","url":null,"abstract":"<div><h3>Introduction</h3><div>The Utah Pediatric Trauma Network (UPTN), established in 2019, is a collaboration of hospitals that have implemented guidelines to optimize pediatric trauma care. The purpose of this study was to determine whether preventable transfer (PT) rates decreased following the establishment of the UTPN and what hospital characteristics were associated with decreased preventable transfers.</div></div><div><h3>Methods</h3><div>Children with traumatic injuries transferred from hospitals in the UPTN to the state’s only Level I Pediatric Trauma Center between 2013 and 2023 were retrospectively analyzed. A PT was a child discharged within 48 h of arrival without surgical intervention or advanced imaging studies. The main hospital-level outcome measure was an overall decrease in PT after the UPTN establishment in 2019.</div></div><div><h3>Results</h3><div>After 2019, 34 of the 46 hospitals meeting inclusion criteria saw a decrease in the percentage of PTs, while 12 saw an increase in PT rate, with an overall median change of −7 % (IQR -14 %, 0 %). We observed that hospitals with decreased PT had higher rates of PT before the establishment of the UPTN and had higher overall transfer volume than hospitals without a decreased PT rate. Can we put the overall p value in this?</div></div><div><h3>Conclusion</h3><div>Most hospitals were able to successfully decrease PT rates following the creation of the UPTN. More smaller hospitals did not successfully decrease PT, so more work may need to be done to target lower-volume hospitals.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 2","pages":"Article 162004"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Ultrasound Reliably Detect Negative Appendectomy in Pediatric Patients?","authors":"Mohamed Jallouli,&nbsp;Ahmed Elsharkawy,&nbsp;Ahmed Bahgat Soliman,&nbsp;Mohamed Zouari","doi":"10.1016/j.jpedsurg.2024.161691","DOIUrl":"10.1016/j.jpedsurg.2024.161691","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 2","pages":"Article 161691"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Features Associated with Delayed Diagnosis of Appendicitis in Children: A Retrospective Analysis of 1411 Cases","authors":"Mohamed Zouari,&nbsp;Manel Belhajmansour,&nbsp;Oumaima Jarboui,&nbsp;Najoua Ben Kraiem,&nbsp;Riadh Mhiri","doi":"10.1016/j.jpedsurg.2024.161878","DOIUrl":"10.1016/j.jpedsurg.2024.161878","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 2","pages":"Article 161878"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Preoperative Intrahepatic Portal Venous Classification System in Guiding Preoperative Surgical Decisions and Predicting Hypotensive Effects After Meso-rex Bypass for Children With EHPVO","authors":"Xiaopan Chang ,&nbsp;Lu Liu ,&nbsp;Jieqin Wang ,&nbsp;Qifeng Liang ,&nbsp;Jiankun Liang ,&nbsp;Zhenyin Liu ,&nbsp;Zhe Wen","doi":"10.1016/j.jpedsurg.2024.161990","DOIUrl":"10.1016/j.jpedsurg.2024.161990","url":null,"abstract":"<div><h3>Background</h3><div>The categorization of intrahepatic portal venous system (IHPS) patterns using wedged hepatic venous portography (WHVP) has proven to be an effective tool in the preoperative evaluation of Rex recessus and in identifying pediatric patients with extrahepatic portal vein obstruction (EHPVO) who are suitable for meso-Rex bypass (MRB). Despite this classification system being proposed a decade ago, its clinical application remains underutilized.</div></div><div><h3>Methods</h3><div>A single-center retrospective study of 182 children with EHPVO was conducted between October 2014 and July 2023 when MRB was attempted. Data on demographics, etiology, imaging examinations, procedures, and follow-up were collected for 161 patients included. Two interventional radiologists used deVille’s method to classify patients into types A to E based on WHVP imaging, with interobserver agreement analyzed. Associations between IHPS patterns and surgical outcomes following MRB were investigated.</div></div><div><h3>Results</h3><div>Two radiologists had a high level of agreement on identifying IHPS patterns and suitable patients for MRB. Of the 161 cases, 130 were type A, 10 were type B, 5 were type C, 7 were type D, and 9 were type E. One hundred and forty-five patients with types A, B and C underwent successful MRB, showing feasibility for 90% of patients. Children categorized as types A and B experienced more significant benefits than type C, including intraoperatively decreased portal vein pressure, esophageal/gastric varices relief, decreased portal venous collaterals and a lower rate of bypass occlusion after one year. The surgical outcomes of patients with types A and B were not influenced by the diameter of the Rex recessus as suggested by WHVP.</div></div><div><h3>Conclusions</h3><div>The majority of pediatric patients with EHPVO in mainland China have opportunities to receive successful MRB. There are potential differences in the etiology of Chinese and Western patients. The IHPS classification system aids in guiding preoperative surgical decisions and predicting hypotensive effects after MRB. Type C patients should be carefully chosen for MRB.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 2","pages":"Article 161990"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Physical Injury: Routine Screening for Acute Stress Disorder and Posttraumatic Stress Disorder in Pediatric Trauma Patients – A Longitudinal Cohort Pilot Study","authors":"Norah E. Liang ,&nbsp;Katherine Alvarez ,&nbsp;Kyla Dalusag,&nbsp;Katy Chan,&nbsp;Brittney Bunnell,&nbsp;Melanie Stroud,&nbsp;Kathleen Steele,&nbsp;Stephanie D. Chao","doi":"10.1016/j.jpedsurg.2024.161982","DOIUrl":"10.1016/j.jpedsurg.2024.161982","url":null,"abstract":"<div><h3>Introduction</h3><div>Early identification of children at risk for PTSD is critical for improving mental health outcomes after traumatic injury. Currently, there is no standard PTSD screen for pediatric trauma patients and limited data on long-term quality of life for those who screen positive.</div></div><div><h3>Methods</h3><div>In 2022, we piloted a comprehensive routine screening program for ASD and PTSD at our Level I PTC. All admitted trauma patients ≥8 years old were eligible for screening. Inpatients were administered the ASC3. Those who screened positive were referred for follow-up and repeat mental health evaluation. PTSD screening (CTSQ, CPSS) and quality-of-life screening (PedsQL™) surveys were administered to eligible discharged trauma patients at 1-month post-injury. Children who screened positive on the CTSQ or CPSS were referred for behavioral health services.</div></div><div><h3>Results</h3><div>205 children were screened for ASD using the ASC3. 49/205 children (23.9 %) had a positive screen (score ≥3). 56 children completed PTSD screening at 1-month post-discharge. 14/54 children (25.9 %) screened positive on CTSQ, and 8/50 children (16 %) screened positive on CPSS. There was a significant positive correlation between CTSQ and CPSS scores (r 0.76, <em>∗P</em>&lt;<em>0.0001</em>). When stratified by screening results, patients who screened positive on CTSQ and CPSS were found to have the most significant correlations with poor School and Emotional Functioning on their quality-of-life inventory.</div></div><div><h3>Conclusion</h3><div>Early screening for ASD may be predictive of later development of PTSD in children. Screening using previously validated tools (ASC3, CTSQ, CPSS) were effective in identifying children with negative emotional functioning lasting beyond the acute phase of physical recovery following injury. CTSQ and CPSS both performed well for screening at one-month post-discharge. Early identification can facilitate timely referral to mental health services to potentially minimize long-term socioemotional impact of PTSD.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 2","pages":"Article 161982"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing an Effective Off-the-job Training Model and an Automated Evaluation System for Thoracoscopic Esophageal Atresia Surgery","authors":"Akihiro Yasui ,&nbsp;Yuichiro Hayashi ,&nbsp;Akinari Hinoki ,&nbsp;Hizuru Amano ,&nbsp;Chiyoe Shirota ,&nbsp;Takahisa Tainaka ,&nbsp;Wataru Sumida ,&nbsp;Satoshi Makita ,&nbsp;Yoko Kano ,&nbsp;Aitaro Takimoto ,&nbsp;Yoichi Nakagawa ,&nbsp;Maeda Takuya ,&nbsp;Daiki Kato ,&nbsp;Yousuke Gohda ,&nbsp;Jiahui Liu ,&nbsp;Yaohui Guo ,&nbsp;Kensaku Mori ,&nbsp;Hiroo Uchida","doi":"10.1016/j.jpedsurg.2024.06.023","DOIUrl":"10.1016/j.jpedsurg.2024.06.023","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric minimally invasive surgery requires advanced technical skills. Off-the-job training (OJT), especially when using disease-specific models, is an effective method of acquiring surgical skills. To achieve effective OJT, it is necessary to provide objective and appropriate skill assessment feedback to trainees. We aimed to construct a system that automatically evaluates surgical skills based on forceps movement using deep learning (DL).</div></div><div><h3>Methods</h3><div>Using our original esophageal atresia OJT model, participants were tasked with performing esophageal anastomosis. All tasks were recorded for image analysis. Based on manual objective skill assessments, each participant's surgical skills were categorized into two groups: good and poor. The motion of the forceps in both groups was used as training data. Employing this training data, we constructed an automated system that recognized the movement of forceps and determined the quality of the surgical technique.</div></div><div><h3>Results</h3><div>Thirteen participants were assigned to the good skill group and 32 to the poor skill group. These cases were validated using an automated skill assessment system. This system showed a precision of 75%, a specificity of 94%, and an area under the receiver operating characteristic curve of 0.81.</div></div><div><h3>Conclusions</h3><div>We constructed a system that automatically evaluated the quality of surgical techniques based on the movement of forceps using DL. Artificial intelligence diagnostics further revealed the procedures important for suture manipulation.</div></div><div><h3>Levels of Evidence</h3><div>Level IV</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 2","pages":"Article 161615"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Report of the 57th Annual Meeting of the Pacific Association of Pediatric Surgeons","authors":"Patrick Ho Yu Chung,&nbsp;Mary Brindle,&nbsp;PAPS Publication Committee","doi":"10.1016/j.jpedsurg.2024.162071","DOIUrl":"10.1016/j.jpedsurg.2024.162071","url":null,"abstract":"","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 2","pages":"Article 162071"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intradyadic Correlation Between Parent-reported and Child-reported Quality of Life in Patients With Anorectal Malformation and Hirschsprung's Disease in Comparison to Healthy Controls","authors":"Suganthi Rajasegaran ,&nbsp;Nur Aini Ahmad ,&nbsp;Shung Ken Tan ,&nbsp;Abhirrami Lechmiannandan ,&nbsp;Yew-Wei Tan ,&nbsp;Anand Sanmugam ,&nbsp;Srihari Singaravel ,&nbsp;Shireen Anne Nah","doi":"10.1016/j.jpedsurg.2024.161687","DOIUrl":"10.1016/j.jpedsurg.2024.161687","url":null,"abstract":"<div><h3>Background</h3><div>Quality of life (QOL) is an important clinical endpoint in paediatric chronic conditions. How parent-proxy reports differ from child self-reported QOL in patients with anorectal malformation (ARM) and Hirschsprung's disease (HD) has not been well examined to date. This study evaluates agreement between parent-proxy and child-reported QOL scores in ARM and HD patients compared to healthy controls.</div></div><div><h3>Methods</h3><div>We recruited ARM and HD patients aged 5–17 years and their parents at four tertiary referral centres between December 2020 to February 2023 who had corrective surgery done &gt;12 months prior. Healthy controls were age-matched and gender-matched. They completed the Pediatric Quality of Life Inventory™ (PedsQL™) Generic Core Scales and General Well-Being (GWB) Scale. The questionnaires were administered in parallel parent-proxy-report and child self-report formats. Appropriate statistical analysis was performed with p &lt; 0.05 significance. Data are reported as median (interquartile range). Ethical approval was obtained.</div></div><div><h3>Results</h3><div>There were 65 ARM, 54 HD and 83 controls. There were no significant differences between parent-reported scores and child-reported scores overall in the Total, Psychosocial Health and Physical Health components of Core Scales for ARM, HD and controls. However, parent-reported scores were significantly higher than child-reported scores overall in ARM, HD and controls in the GWB Scale.</div></div><div><h3>Conclusion</h3><div>Our findings show that parent-rated and child-rated overall QOL was similar in Core Scales for ARM, HD, and controls. However, parents overestimated child's overall GWB for ARM, HD and controls. This highlights the importance of capturing the perspectives of both parents and children to inform strategies to improve patient care.</div></div><div><h3>Level of Evidence</h3><div>Level III.</div></div>","PeriodicalId":16733,"journal":{"name":"Journal of pediatric surgery","volume":"60 2","pages":"Article 161687"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}