Journal of the American College of Cardiology最新文献

{"title":"Survival Outcomes After Sudden Cardiac Arrest in Young Competitive Athletes From the United States","authors":"Bradley J. Petek, Timothy W. Churchill, Nathaniel Moulson, Randi Delong, Mary Catherine Minnig, Stephanie A. Kliethermes, Aaron L. Baggish, Joseph J. Maleszewski, Kristen L. Kucera, Kimberly G. Harmon, Jonathan A. Drezner","doi":"10.1016/j.jacc.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.jacc.2025.03.006","url":null,"abstract":"<h3>Background</h3>Sudden cardiac arrest (SCA) is the leading cause of death among young competitive athletes during sports and exercise. A detailed analysis of survival outcomes should inform prevention strategies.<h3>Objectives</h3>The purpose of this study was to determine survival outcomes and trends following SCA among young competitive athletes in the United States and to explore outcomes based on race and exertional status.<h3>Methods</h3>This observational study identified cases of SCA among young competitive athletes through longitudinal surveillance by the National Center for Catastrophic Sports Injury Research from July 1, 2014, to June 30, 2023. Young athletes ≥11 years of age competing in middle school, high school, club, college, or semiprofessional/professional sports, and former athletes (within 1 year of participation) with SCA during exercise, rest, or sleep were included. The primary outcome was survival from SCA. Multivariable log binomial regression estimated survival proportion ratios by race and exertional status.<h3>Results</h3>A total of 641 athletes with SCA were identified during the 9-year study period (mean age 17 ± 3 years; 85% male). Overall survival was 49% (315 of 641). Survival from SCA occurring during exercise was 57% (275 of 481). The majority of cases were in high school athletes (61%), followed by college (15%) and middle school (12%) athletes. Overall survival (range 30%-66% per academic year; <em>P =</em> 0.007) and survival from exertional SCA (range 38%-72% per academic year; <em>P =</em> 0.03) both increased throughout the study period. Among exertional SCA events, survival was higher among athletes who experienced SCA during a game/competition vs practice/training (70% vs 53%; <em>P =</em> 0.001). Black race (RR: 0.63; 95% CI: 0.53-0.76), Other race (RR: 0.69; 95% CI: 0.50-0.94), and nonexertional SCA (RR: 0.43; 95% CI: 0.32-0.59) were associated with lower survival from SCA after adjusting for sex and level of competition.<h3>Conclusions</h3>Although survival from SCA among young competitive athletes in the United States has improved in the last decade, important racial disparities in outcomes were observed warranting additional research and prevention strategies.","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"89 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Evidence in Cardiogenic Shock: Why Bigger, Bolder Trials are Needed","authors":"Alastair G. Proudfoot, Jacob E. Møller, Mark C. Petrie, Marc D. Samsky","doi":"10.1016/j.jacc.2025.03.510","DOIUrl":"https://doi.org/10.1016/j.jacc.2025.03.510","url":null,"abstract":"No Abstract","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"131 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Intra-Aortic Balloon Support for Heart Failure-Related Cardiogenic Shock: A Randomized Clinical Trial","authors":"Nuccia Morici, Alice Sacco, Simone Frea, Matteo Rota, Luca Villanova, Carol Gravinese, Carlotta Sorini Dini, Nicoletta D’Ettore, Giulia Maj, Giulia D’Elio, Luciano Potena, Serafina Valente, Mario Sabatino, Giovanna Viola, Laura Garatti, Giovanni Amedeo Tavecchia, Letizia Bertoldi, Fabrizio Oliva, Navin K. Kapur, Guido Tavazzi, Federico Pappalardo","doi":"10.1016/j.jacc.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.jacc.2025.03.003","url":null,"abstract":"<h3>Background</h3>The impact of intra-aortic balloon pump (IABP) on survival and successful bridging to heart replacement therapies (HRT) in patients with heart failure–cardiogenic shock (HF-CS) remains unclear.<h3>Objectives</h3>The purpose of this study was to evaluate the effect of early IABP use vs standard care on 60-day survival or successful bridging to HRT.<h3>Methods</h3>In the multicenter, prospective Altshock-2 (Study on Early Intra-aortic Balloon Pump Placement in Acute Decompensated Heart Failure Complicated by Cardiogenic Shock), patients with Society for Cardiovascular Angiography and Interventions stage B, C, or D HF-CS and suitable for HRT were randomized to receive early IABP plus standard care (IABP group) or standard care (control group). The primary endpoint was survival or successful bridge to HRT at 60 days. Secondary endpoints included overall survival, maximum inotropic score, and maximum sequential organ failure assessment score.<h3>Results</h3>In total, 53 patients were randomized to IABP and 48 to standard care. Patients were Society for Cardiovascular Angiography and Interventions stage B (28%, n = 28), C (57%, n = 56), and D (15%, n = 16). At the prespecified interim analysis, the trial was stopped because of futility. The primary endpoint was reached in 43 patients (81%) in the IABP group and 36 patients (75%) in the control group (HR: 0.72; 95% CI: 0.31-1.68; <em>P</em> = 0.45). A total of 37 patients (37%) underwent HRT within the 60-day follow-up. Four patients were escalated in the study group (7.5%) vs 2 in the control group (4.2%). Additionally, 6 patients (13%) initially assigned to standard care crossed over to IABP. Complications were comparable between groups.<h3>Conclusions</h3>Routine early IABP plus standard care, compared with standard care, did not significantly improve survival or successful bridging to HRT in patients with HF-CS. (Study on Early Intra-aortic Balloon Pump Placement in Acute Decompensated Heart Failure Complicated by Cardiogenic Shock [Altshock-2]; <span><span>NCT04369573</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>)","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"21 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bursting the Balloon: The End of Intra-Aortic Balloon Pumps for Cardiogenic Shock?","authors":"Clément Delmas, Miloud Cherbi, François Roubille, Christophe Vandenbriele","doi":"10.1016/j.jacc.2025.03.479","DOIUrl":"https://doi.org/10.1016/j.jacc.2025.03.479","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>Funding Support and Author Disclosures</h2>Drs Delmas and Vandenbriele have received consulting and speaking fees from Abiomed. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.</section></section>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"31 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143737079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"5-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis","authors":"John K. Forrest, Steven J. Yakubov, G. Michael Deeb, Hemal Gada, Mubashir A. Mumtaz, Basel Ramlawi, Tanvir Bajwa, John Crouch, William Merhi, Stephane Leung Wai Sang, Neal S. Kleiman, George Petrossian, Newell B. Robinson, Paul Sorajja, Ayman Iskander, Pierre Berthoumieu, Didier Tchétché, Christopher Feindel, Eric M. Horlick, Shigeru Saito, Michael J. Reardon","doi":"10.1016/j.jacc.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.jacc.2025.03.004","url":null,"abstract":"<h3>Background</h3>The Evolut Low Risk trial demonstrated that transcatheter aortic valve replacement (TAVR) was noninferior to surgery for the primary endpoint of all-cause mortality or disabling stroke at 2 years. Outcomes at 5 years have not been reported.<h3>Objectives</h3>This study sought to evaluate 5-year clinical and hemodynamic outcomes with TAVR vs surgery in patients from the Evolut Low Risk trial.<h3>Methods</h3>We randomly assigned low-risk patients with severe aortic stenosis to TAVR or surgery. The primary endpoint was a composite of all-cause mortality or disabling stroke. Secondary endpoints included clinical, echocardiographic, and quality-of-life outcomes through 5 years.<h3>Results</h3>A total of 1,414 patients underwent an attempted implant (n = 730 TAVR, n = 684 surgery). The mean age was 74 years (range 51-88 years), and women accounted for 35% of patients. At 5 years the Kaplan-Meier estimate for the primary endpoint of all-cause mortality or disabling stroke was 15.5% for the TAVR group and 16.4% for the surgery group (<em>P</em> = 0.47). The Kaplan-Meier estimates in the TAVR and surgery groups for all-cause mortality were 13.5% and 14.9% (<em>P</em> = 0.39) and for disabling stroke were 3.6% and 4.0% (<em>P</em> = 0.57). Cardiovascular mortality was 7.2% in the TAVR group and 9.3% in the surgery group (<em>P</em> = 0.15). Noncardiovascular mortality in the TAVR group was 6.8% and 6.2% in the surgery group (<em>P</em> = 0.73). A site-level vital status sweep was performed for patients who were lost to follow-up or withdrew from the study. With the addition of these patients, the all-cause mortality rate at 5 years for patients undergoing TAVR was 14.7% and for surgery was 15.2% (<em>P</em> = 0.74). Over 5 years, valve reintervention rate was 3.3% for TAVR and 2.5% for surgery (<em>P</em> = 0.44). A sustained improvement in quality of life was observed in both treatment arms with mean Kansas City Cardiomyopathy Questionnaire summary score of 88.3 ± 15.8 in TAVR and 88.5 ± 15.8 in surgery.<h3>Conclusions</h3>At 5 years, patients with severe aortic stenosis who were treated with either TAVR or surgery had comparable rates of all-cause mortality or disabling stroke. Valve durability and performance were excellent in both arms. This midterm evaluation reinforces the position of TAVR as noninferior to surgery in patients with severe aortic stenosis at low surgical risk (Medtronic Evolut Transcatheter Aortic Valve Replacement in Low Risk Patients; <span><span>NCT02701283</span><svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"><path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"></path></svg></span>)","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"82 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolut Low-Risk Trial 5-Year Result: We’re Halfway There","authors":"Tsuyoshi Kaneko, Josep Rodés-Cabau, Alan Zajarias, Stephan Windecker","doi":"10.1016/j.jacc.2025.03.428","DOIUrl":"https://doi.org/10.1016/j.jacc.2025.03.428","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>Funding Support and Author Disclosures</h2>Dr Kaneko has been a consultant for Medtronic, Edwards Lifesciences, Abbott Vascular, 4C Medical, Anteris, and Johnson &amp; Johnson. Dr Rodés-Cabau has received institutional research grants and consultant/speaker fees from Edwards Lifesciences and Medtronic. Dr Zajarias has been a consultant for Edwards Lifesciences, Medtronic, and Anteris. Dr Windecker has received research, travel, and/or educational grants to the institution from Abbott, Abiomed, Alnylam, Amicus Therapeutics, Amgen,</section></section>","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"60 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of ANGPTL3 Inhibition With Solbinsiran in Preclinical and Early Human Studies","authors":"Kausik K. Ray, Helle Linnebjerg, Laura F. Michael, Xi Shen, Xiaosu Ma, Shufen Lim, Eugene Y. Zhen, Henryk Dudek, Marc Abrams, Utsav Saxena, Anton Turanov, Stephen J. Nicholls, Giacomo Ruotolo","doi":"10.1016/j.jacc.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.jacc.2025.03.005","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;The residual cardiovascular risk associated with hypertriglyceridemia and remnant particles supports efforts to develop effective novel therapeutic approaches. Angiopoietin-like protein 3 (ANGPTL3) inhibits lipoprotein and endothelial lipases, and Mendelian randomization studies associate lower ANGPTL3 activity with lower triglycerides, and lower cardiovascular risk.&lt;h3&gt;Objectives&lt;/h3&gt;The aim of this study was to evaluate the impact of solbinsiran, an N-acetylgalactosamine-conjugated small interfering RNA developed to inhibit hepatic translation of &lt;em&gt;ANGPTL3&lt;/em&gt; messenger RNA (mRNA), on ANGPTL3 and lipid levels in preclinical models and humans.&lt;h3&gt;Methods&lt;/h3&gt;In preclinical studies, the impact of solbinsiran on ANGPTL3 levels was assessed in mouse and nonhuman primate models. The phase 1 clinical study enrolled participants with mixed dyslipidemia. In the single-ascending-dose study, participants received single subcutaneous doses of solbinsiran (24-960 mg) or matching placebo. In the repeat-dose study, subcutaneous solbinsiran (208 or 480 mg) or matching placebo on days 1 and 29 was evaluated. Safety, pharmacokinetics, and effect on levels of ANGPTL3 and lipid parameters were evaluated over 169 days.&lt;h3&gt;Results&lt;/h3&gt;In mice transiently expressing human &lt;em&gt;ANGPTL3&lt;/em&gt;, a single dose of solbinsiran reduced hepatocyte &lt;em&gt;ANGPTL3&lt;/em&gt; mRNA expression by 65% vs vehicle-treated mice. In cynomolgus monkeys, mean ± SEM reductions in hepatic &lt;em&gt;ANGPTL3&lt;/em&gt; mRNA expression up to 73% ± 2% (&lt;em&gt;P&lt;/em&gt; &lt; 0.0001) and serum ANGPTL3 protein expression up to 69% ± 4% (&lt;em&gt;P&lt;/em&gt; &lt; 0.001) were seen vs vehicle-treated monkeys. In humans, a single dose of solbinsiran resulted in dose-dependent mean ± SD percentage reductions from baseline in ANGPTL3 up to 86% ± 4%, triglycerides up to 73% ± 7%, low-density lipoprotein (LDL) cholesterol up to 30% ± 16%, non–high-density lipoprotein cholesterol up to 41% ± 12%, and apolipoprotein B up to 30% ± 11%, with sustained effects at higher doses (&lt;em&gt;P&lt;/em&gt; &lt; 0.0001 for all). The repeat-dose study demonstrated reductions in ANGPTL3 of 89% ± 6%, triglycerides up to 70% ± 13%, LDL cholesterol up to 42% ± 14%, non–high-density lipoprotein cholesterol up to 46% ± 14%, and apolipoprotein B up to 36% ± 13% (&lt;em&gt;P&lt;/em&gt; &lt; 0.0001 for all). Nuclear magnetic resonance lipoprotein analysis demonstrated reductions in the total number of triglyceride-rich lipoprotein and LDL particles with solbinsiran. Adverse events were mostly mild in severity, with similar incidence in solbinsiran- and placebo-treated participants.&lt;h3&gt;Conclusions&lt;/h3&gt;Solbinsiran inhibits hepatic &lt;em&gt;ANGPTL3&lt;/em&gt; translation and results in significant reductions in all atherogenic lipoproteins in mixed dyslipidemia. The impact of this approach on cardiovascular outcomes remains to be determined. (A Study of LY3561774 in Participants With Dyslipidemia; &lt;span&gt;&lt;span&gt;NCT04644809&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"fals","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"26 1","pages":""},"PeriodicalIF":24.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SGLT2 INHIBITORS AND ARRHYTHMIA RISK IN HEART FAILURE: A META-ANALYSIS OF SEVEN DOUBLE-BLIND, PLACEBO-CONTROLLED RANDOMIZED TRIALS","authors":"Suchith Boodgere Suresh,&nbsp;Angel Goenawan,&nbsp;Urja Sanghvi,&nbsp;ARASHDEEP SINGH,&nbsp;Jahannvi Kasodariya,&nbsp;Vineet Chandak,&nbsp;Saifullah Syed,&nbsp;Fekadesilassie Moges,&nbsp;Binay K. Panjiyar,&nbsp;Sourav Sudan,&nbsp;Akshat Banga","doi":"10.1016/S0735-1097(25)00547-9","DOIUrl":"10.1016/S0735-1097(25)00547-9","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 12","pages":"Page 62"},"PeriodicalIF":21.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IMPACT OF VEIN OF MARSHALL ETHANOL INFUSION IN ATRIAL FIBRILLATION: A SYSTEMATIC REVIEW AND META-ANALYSIS","authors":"Eduardo Dan Itaya,&nbsp;Caique M P Ternes,&nbsp;André Rivera,&nbsp;Lara Melo Soares Pinho De Carvalho,&nbsp;Robert D’Angelo,&nbsp;Andre d’Avila","doi":"10.1016/S0735-1097(25)00534-0","DOIUrl":"10.1016/S0735-1097(25)00534-0","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 12","pages":"Page 49"},"PeriodicalIF":21.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INFLAMMATORY MARKERS IN ATRIAL FIBRILLATION PATIENTS PREDICT CATHETER ABLATION OUTCOMES: INSIGHTS FROM DECAFF II","authors":"Tarek Hassan Ayoub,&nbsp;Hadi Younes,&nbsp;Han Feng,&nbsp;Mario Mekhael,&nbsp;Yingshuo Liu,&nbsp;Ghassan Bidaoui,&nbsp;Mayana Bsoul,&nbsp;Christian Massad,&nbsp;Chan Lim,&nbsp;Yishi Jia,&nbsp;Abboud Hassan,&nbsp;Swati Rao,&nbsp;Omar Kreidieh,&nbsp;Amitabh C. Pandey,&nbsp;Nassir F. Marrouche","doi":"10.1016/S0735-1097(25)00512-1","DOIUrl":"10.1016/S0735-1097(25)00512-1","url":null,"abstract":"","PeriodicalId":17187,"journal":{"name":"Journal of the American College of Cardiology","volume":"85 12","pages":"Page 27"},"PeriodicalIF":21.7,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}