Journal of Surgical Research最新文献

{"title":"Perioperative Music Therapy in Colorectal Surgery: A Review of Cost-effectiveness and Clinical Impact.","authors":"Rohan Kapoor, M D Ray","doi":"10.1016/j.jss.2024.12.051","DOIUrl":"https://doi.org/10.1016/j.jss.2024.12.051","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response Regarding: Response to the Letter to the Editor.","authors":"Jorrit G Verhoeven, Saskia H Van Bergen, Ellaha Kakar, Johannes Jeekel, Erwin Birnie, Markus Klimek","doi":"10.1016/j.jss.2024.12.052","DOIUrl":"https://doi.org/10.1016/j.jss.2024.12.052","url":null,"abstract":"","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Focal Thoracic Ossification of the Ligamentum Flavum by Percutaneous Posterolateral Transforaminal Endoscopic Surgery Under Local Anesthesia: A Case Series Study.","authors":"Jing-Lai Xue, Huo-Huo Xue, Jun-Qin Qiu, Wei-Liang Cui, Chao-Hui Wang, Zhong Liao","doi":"10.1016/j.jss.2024.11.020","DOIUrl":"https://doi.org/10.1016/j.jss.2024.11.020","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive techniques, such as percutaneous endoscopic discectomy, are increasingly utilized for treating focal thoracic ossification of the ligamentum flavum (TOLF), where their safety and efficacy needs to be further confirmed. The purpose of this study was to investigate the safety and efficacy of percutaneous posterolateral transforaminal endoscopic surgery under local anesthesia for treating focal TOLF.</p><p><strong>Methods: </strong>This case series study reviewed medical records of 12 cases diagnosed with focal TOLF who underwent percutaneous posterolateral transforaminal endoscopic surgery under local anesthesia from December 2016 to July 2019 at Fuzhou Second Hospital. Outcomes were functional status and complications. Functional status was evaluated by Epstein criteria and the Japanese Orthopedic Association score 1 d after surgery. The median follow-up time was 58.5 (47, 62) mo.</p><p><strong>Results: </strong>Patients' median age was 65 (47, 70) y and 58.3% were female. The median surgical duration was 156 min and intraoperative blood loss was 10-30 mL. The Japanese Orthopedic Association score improved significantly from preoperatively to postoperatively (6 [5, 6] to 12.5 [12, 13], P < 0.001). Based on Epstein's criteria, treatment outcomes were excellent in nine cases, good in two cases, and fair in one case. All included patients returned to free movement from the second day after surgery. No severe complications were reported during follow-up.</p><p><strong>Conclusions: </strong>Percutaneous posterolateral transforaminal endoscopic surgery under local anesthesia can achieve satisfactory safety and efficacy for treating TOLF. No severe complication was noticed during long-term follow-up.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"382-388"},"PeriodicalIF":1.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Options for Buerger Disease: A Systematic Review and Meta-Analysis of Outcomes.","authors":"Ramin Shekouhi, Mohammed Mumtaz, Humza Naqvi, Armina Azizi, Kristina M Crawford, Benjamin N Jacobs, Harvey Chim","doi":"10.1016/j.jss.2024.12.034","DOIUrl":"https://doi.org/10.1016/j.jss.2024.12.034","url":null,"abstract":"<p><strong>Introduction: </strong>Uncertainties exist regarding the optimal management strategy for patients with thromboangiitis obliterans (TAOs). The aim of this study was to investigate the safety and effectiveness of common interventions used for treating patients with TAO.</p><p><strong>Methods: </strong>Endovascular treatment, revascularization, sympathectomy, stem cell therapy (SCT), and nonsurgical interventions were selected for inclusion in the study. Changes in mean visual analogue scale score and ankle brachial index (ABI) values were evaluated. In addition, the rate of ulcer healing, postintervention amputation, and overall complication rates were compared across interventions.</p><p><strong>Results: </strong>A total of 1262 TAO patients (1159 males, 84 females), with a mean age of 38.4 ± 7.8 ys, were included in this systematic review. With an amputation rate of 16.6%, the endovascular treatment group showed statistically significant improvements in mean ABI and visual analogue scale scores (P < 0.05). There was a greater increase in ABI postoperatively with endovascular treatment compared to SCT (P < 0.05), and also a greater increase in ABI postoperatively with revascularization compared to SCT (P < 0.05). Meta-regression showed that both endovascular treatment and open surgical revascularization were superior to stem cell treatment for postoperative mean ABI improvement (P < 0.05). Interestingly, the rate of postoperative amputation was lower in the SCT group compared with the other two interventions.</p><p><strong>Conclusions: </strong>Our results indicated that all three interventions may be a reasonable therapeutic option for TAO. Endovascular intervention and open revascularization demonstrated superior outcomes.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"371-381"},"PeriodicalIF":1.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Extremity Penetrating Trauma Care Associated With Race and Income in the United States of America.","authors":"Anika G Gnaedinger, Andrew Tian-Yang Yu, Jaafar Hadi, Sarah Saliba, William M Tian, Joseph Fernandez, Cory J Vatsaas, Suresh Agarwal, Krista Haines","doi":"10.1016/j.jss.2024.11.045","DOIUrl":"https://doi.org/10.1016/j.jss.2024.11.045","url":null,"abstract":"<p><strong>Introduction: </strong>For lower extremity penetrating traumas (LEPT), the impact of race and insurance status, as a surrogate of socioeconomic status, is still not fully elucidated. This study aims to explore the relationship between these variables and the likelihood of receiving an amputation for LEPT to further identify disparities in trauma care.</p><p><strong>Methods: </strong>We analyzed the 2017-2019 Trauma Quality Improvement Program databases to identify patients with LEPT. Univariate analysis of various patient factors was performed for mortality. Linear and logistic multivariate regressions were then conducted for the primary and secondary outcomes using significant variables from the univariate analysis. Finally, multivariate logistic regression identified associations between race, ethnicity, primary payor, and amputation rates.</p><p><strong>Results: </strong>The independent factors significantly linked to amputation included Black race (odds ratio (OR) 0.745, P < 0.001), Medicare (OR 0.557, P < 0.001), Medicaid (OR 0.697, P < 0.001), and uninsured status (OR 0.661, P < 0.001). We additionally evaluated the incidence of death among the penetrating trauma victims and determined that male (OR 2.008, P < 0.001), Black (OR 1.801, P = 0.001), and uninsured patients (OR 1.910, P = 0.003) were more likely to die during admission than the privately insured.</p><p><strong>Conclusions: </strong>Compared to privately insured victims, uninsured patients and those on Medicaid and Medicare experience lower amputation rates post-LEPT. Black patients were found to have not only a decreased likelihood of receiving an amputation following LEPT but also an increased rate of mortality during admission compared to Caucasian victims. These findings underscore the urgency to address institutional barriers hindering vulnerable populations from accessing appropriate care after trauma.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"364-370"},"PeriodicalIF":1.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Cardiothoracic Fellows and Clinical and Financial Outcomes in Coronary Surgery.","authors":"Brandon Peine, Hanna Long, J Preston Bethea, Yuanyuan Fu, Rob Allman, Olasunkanmi Kehinde, Dmitry Tumin, Linda Kindell, William Irish, Shahab A Akhter","doi":"10.1016/j.jss.2024.12.041","DOIUrl":"https://doi.org/10.1016/j.jss.2024.12.041","url":null,"abstract":"<p><strong>Introduction: </strong>Mounting financial pressures on academic institutions highlight the need to understand the effect on outcomes from trainee involvement in cardiac surgery. The purpose of this study is to examine the association between cardiothoracic fellows and clinical and financial outcomes in coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>Data for all patients from 2017 to 2022 at a single institution who underwent nonemergent, isolated, open CABG were included in the study, with patients grouped by whether there was fellow operative participation. Financial and clinical outcomes were compared between the two groups using multivariable regression and generalized estimating equations to control for variation in patient characteristics and attending cardiac surgeon practices.</p><p><strong>Results: </strong>A total of 1997 patients met criteria for study inclusion, with 632 (31.5%) cases that had fellow participation and 1365 (68.4%) that did not. Patients in the fellow participation group had a 0.8% higher median preoperative risk score than those that did not have fellow participation. Fellow participation was associated with significantly longer total case length (61 mins) but no differences in postoperative clinical outcomes. There was an increased median total hospitalization cost of approximately $2200 in cases with fellow participation, likely attributable to increased intraoperative costs from longer case times.</p><p><strong>Conclusions: </strong>While CT surgery fellow participation was associated with longer operative times and a small increase in hospitalization cost in CABG, there were no significant differences in clinical outcomes. Continuing to train cardiothoracic surgery fellows in this procedure is safe and would not be expected to significantly impact reimbursement under bundled payment models.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"358-363"},"PeriodicalIF":1.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Rehabilitation Services for Victims of Violence.","authors":"Megan G Janeway, Ella Cornell, Sophia M Smith, Anne K Buck, Miriam Neufeld, Janice Weinberg, Stephanie D Talutis, Nina Jreige, Victoria Liang, Timothy Munzert, Tracey Dechert, Sabrina E Sanchez, Lisa Allee","doi":"10.1016/j.jss.2024.12.040","DOIUrl":"https://doi.org/10.1016/j.jss.2024.12.040","url":null,"abstract":"<p><strong>Introduction: </strong>Access to rehabilitation services after a traumatic injury improves functional outcomes. No study has examined the association between injury intent, violent versus nonviolent, and receipt of rehabilitation services after injury.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study of injured adult patients admitted to our level I trauma center from January 1, 2014 to December 31, 2021. The primary exposure was violent injury, and the primary outcome was receipt of rehabilitation services upon discharge. An exploratory subgroup analysis evaluated differences in recommended disposition and the reasons for rejection from services.</p><p><strong>Results: </strong>Among 7500 patients, 1677 (22.4%) were violently injured and 5823 (77.6%) were nonviolently injured. Patients were 45% White, 67% male, and 52% had public insurance. Adjusting for age, sex, race, ethnicity, injury severity score, insurance, and length of stay, violently injured patients were 77% less likely to receive inpatient rehabilitation (relative risk ratio 0.23 95% confidence interval [0.18, 0.30], P < 0.001) and 46% less likely to have home services (relative risk ratio 0.54, 95% confidence interval[0.43, 0.69], P < 0.001). A subgroup analysis (n = 328) demonstrated that violently injured patients were more likely to have a downgrade in discharge recommendation (27.8% versus 9.4%, P = 0.04) and more likely to have an emergency department visit within 30 d (32.0% versus 13.3%, P < 0.001).</p><p><strong>Conclusions: </strong>Violent injury is associated with lower likelihood of receiving rehabilitation services. Subgroup analysis indicates this finding associated with facilities' selection bias, and this warrants additional study. Efforts should focus on protecting victims of violence from discrimination during the rehabilitation screening process.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"317-326"},"PeriodicalIF":1.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Gender Disparity in Operative Opportunities for Trainee Surgeons: A Review.","authors":"Sherri Xu, Heidi McAlpine, Katharine Jann Drummond","doi":"10.1016/j.jss.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.jss.2024.12.004","url":null,"abstract":"<p><strong>Introduction: </strong>Assessing gender disparity in surgical trainees' operative opportunities and experience quantifies implicit gender bias and reflects a summation of many smaller biased interactions within the operating room environment. Highlighting gender disparity in surgery informs a platform for advocacy.</p><p><strong>Methods: </strong>A systematic literature search was performed using Medline, Web of Science, OpenMD and Science Direct consistent with the Preferred Reporting Items for Systematic Reviews and Metanalysis guidelines. A Boolean search strategy was used to identify articles relevant to gender in operative surgery. Only English language studies that assessed the gender of surgical trainees with regards to operative cases for total and/or autonomously performed case numbers were included.</p><p><strong>Results: </strong>Fifteen papers assessing the influence of gender on operative opportunities for trainee surgeons were identified. A discrepancy between the operative experiences of men and women trainee surgeons was found. Of eight studies assessing gender differences in total case numbers, four reported women undertaking fewer total cases than men; a similar trend was demonstrated in two studies that failed to reach statistical significance. Eight of eleven studies examining surgical autonomy reported more surgical autonomy afforded to men trainee surgeons than women.</p><p><strong>Conclusions: </strong>A gendered bias in the operative opportunities afforded to trainee surgeons is suggested in the literature, reflecting implicit bias that underlies surgical culture worldwide. Although surgical specialties continue to have vast gender inequity, we fail to leverage talent and the benefits of diverse skills and experience, to the detriment of ourselves and our patients. Quantifying this issue will inform change.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"327-335"},"PeriodicalIF":1.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Intracranial Pressure Monitoring After Open Cranial Procedures Associated With Outcome?","authors":"Peter Aziz, Alison Muller, Christopher Butts, Eugene F Reilly, Anthony Martin, Christopher Lawson, Thomas A Geng, Adrian W Ong","doi":"10.1016/j.jss.2024.12.045","DOIUrl":"https://doi.org/10.1016/j.jss.2024.12.045","url":null,"abstract":"<p><strong>Introduction: </strong>It is unclear if intracranial pressure monitoring (ICPM) after open cranial procedures (craniotomy or craniectomy) (OC) for traumatic brain injury is associated with mortality. We hypothesized that ICPM placed early after OC was associated with lower mortality compared to no ICPM or delayed ICPM placement.</p><p><strong>Methods: </strong>Using 2020-2021 data from the American College of Surgeons Trauma Quality Improvement Program, patients ≥16 y from level 1 and 2 trauma centers who underwent OC were divided into two groups: ICPM placed within 72 h of OC (early) and no ICPM or ICPM placed after 72 h (none/delayed). Outcome was in-hospital mortality. Logistic regression was used to elucidate predictors of mortality.</p><p><strong>Results: </strong>A total of 19,830 patients (early ICPM, 29%) were included. Early patients were more likely to be from level 1 centers (63% versus 60%, P = 0.004), younger (median age 47 versus 60, P < 0.0001), to have a lower Glasgow Coma Score (median, 6 versus 14, P < 0.0001), higher injury severity score (median, 26 versus 26, P < 0.0001), an unreactive pupil (33% versus 18%, P < 0.0001), midline shift >5 mm (69% versus 60%, P < 0.0001), received ≥2 units of blood/first 4 h (14% versus 6%, P < 0.0001) and higher mortality (31% versus 19%, P < 0.0001) compared to none/delayed patients. Controlled for significant variables, early ICPM was associated with increased mortality (odds ratio 1.35, 95% confidence interval 1.24-1.47). Analysis of subjects with isolated brain injury found a similar association (odds ratio 1.32, 95% C1 1.15-1.52).</p><p><strong>Conclusions: </strong>ICPM placed within 72 h of OC was associated with increased mortality. Indications for ICPM after OC should be investigated further in multicenter prospective studies.</p>","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"344-349"},"PeriodicalIF":1.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Surgical Site Infections With Silver Impregnated Dressings in Lower Extremity Bypass Patients.","authors":"Pooja T Desai, Ashar Ata, Sandra R DiBrito, Ralph Clement Darling, Adriana Laser","doi":"10.1016/j.jss.2024.12.036","DOIUrl":"https://doi.org/10.1016/j.jss.2024.12.036","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Surgical site infection (SSI) after lower extremity (LE) bypass surgery is associated with longer length of stay, higher hospital cost, increased morbidity, and even graft loss. Silver impregnated dressings have been used by other surgical subspecialties to decrease SSI with reported success. The National Surgical Quality Improvement Program (NSQIP) published a national expected rate of 7.9% for SSI after open LE bypass surgery in 2018. Our institutional SSI rate in 2018 was 12.8%. In order to reduce this rate, we transitioned to silver impregnated dressings for all LE bypass procedures and studied any subsequent changes in rates of SSI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used NSQIP data to retrospectively study two consecutive cohorts of vascular surgery patients at a single institution who underwent LE bypasses. Inclusion criteria were open infrainguinal LE bypass patients who were selected via Current Procedural Terminology codes. Patients in 2019 who underwent LE bypass received dry sterile dressing (DSD) postoperatively. Patients in 2020 who underwent LE bypass were treated with silver impregnated dressings postoperatively. NSQIP criteria were used to determine if patients in both cohorts developed SSIs within 30 d of surgery. Fischer's exact and Χ2 test were used to compare groups before and after the intervention. Placement of silver dressings in the intervention cohort was confirmed using review of the medical chart and operative billing reports.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 282 patients who underwent LE bypass in 2019 and 2020 met inclusion criteria. The standard of care cohort had 168 patients with DSD, while the cohort after intervention had 114 patients with silver impregnated dressings. The groups were similar in terms of demographics and comorbidities (Table 1). There was a statistically significant reduction in superficial SSI in the silver dressing group compared to the DSD group (9.6% versus 20.8%, P = 0.014, Table 2). There was a 63% compliance with silver dressing placement in the intervention group. This subset of patients with confirmed dressing placement was similar in terms of demographics and comorbidities (Table 3). Superficial SSI in this patient cohort was decreased from 20.8 to 12.5% (P = 0.15, Table 4). There was no observed difference in deep or organ space infections, wound dehiscence, readmission, and return to operating room between both groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study demonstrated a statistically significant reduction in the rate of superficial SSI in patients undergoing open LE bypass with the use of a silver impregnated dressing when compared to a sterile gauze dressing. Although our study does not demonstrate a causal relationship, this relatively inexpensive and low-risk intervention's association with a significant decrease in an otherwise very serious postoperative complication argues for a change in clinical practice or prospective conf","PeriodicalId":17030,"journal":{"name":"Journal of Surgical Research","volume":"306 ","pages":"336-343"},"PeriodicalIF":1.8,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}