Journal of thoracic disease最新文献

{"title":"Risk-stratified early intervention for paucisymptomatic GOLD I-II chronic obstructive pulmonary disease: breaking the diagnostic deadlock.","authors":"Guangqiao Zeng, Jianxing He","doi":"10.21037/jtd-20262-11","DOIUrl":"10.21037/jtd-20262-11","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1003"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and selection of surgical approaches for synchronous multiple primary lung cancer: a narrative review.","authors":"Keyao Huang, Jian Tang","doi":"10.21037/jtd-2026-2146","DOIUrl":"https://doi.org/10.21037/jtd-2026-2146","url":null,"abstract":"<p><strong>Background and objective: </strong>Synchronous multiple primary lung cancer (SMPLC) is a distinct clinical entity in lung cancer management. Because SMPLC differs substantially from intrapulmonary metastasis (IPM) in staging, treatment strategy, and prognosis, accurate assessment of the clonal relationship among multiple malignant pulmonary lesions is essential for treatment planning. This narrative review summarizes the diagnostic basis, preoperative assessment, and selection of surgical approaches for SMPLC and discusses bilateral surgery, residual ground-glass nodules, and future research directions.</p><p><strong>Methods: </strong>PubMed was searched for English- or Chinese-language publications from 1 January 2000 to 18 August 2026 using terms related to SMPLC, IPM, molecular clonality, lobectomy, segmentectomy, wedge resection, bilateral surgery, subsolid nodules, and local therapy. An updated search was performed during revision to capture recent literature on molecular clonality, bilateral video-assisted thoracoscopic surgery (VATS), and residual ground-glass nodules. Relevant guidelines, reviews, cohort studies, systematic reviews, case series, and representative case reports were selected according to their relevance to the clinical scope of this review. No formal risk-of-bias assessment or quantitative synthesis was performed.</p><p><strong>Key content and findings: </strong>Traditional diagnosis is based mainly on lesion distribution and histologic features, but morphology alone has limitations when lesions share similar histologic types. Comprehensive histologic assessment, thin-section computed tomography, and selective molecular testing provide complementary evidence for differentiating SMPLC from IPM. Surgery remains the principal treatment for resectable SMPLC. The choice among lobectomy, anatomical segmentectomy, wedge resection, and combined resection should consider the invasiveness of the dominant and secondary lesions, the number and distribution of lesions, laterality, nodal status, predicted postoperative pulmonary function, comorbidity, and cumulative loss of lung parenchyma. In carefully selected patients with early-stage disease, parenchyma-sparing strategies may provide acceptable oncologic outcomes; however, current evidence is derived mainly from retrospective studies and is limited by selection bias and heterogeneous diagnostic criteria.</p><p><strong>Conclusions: </strong>Accurate multidisciplinary diagnosis and individualized surgical planning are central to SMPLC management. Prospective multicenter studies using standardized diagnostic criteria are needed to clarify the optimal extent of resection, timing of bilateral surgery, and management of residual low-risk ground-glass nodules.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1059"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examined lymph node count and survival in resected non-small cell lung cancer: attenuation of benefit beyond 16 nodes is confined to node-negative disease.","authors":"Huanrong Zhang, Rong Wang, Haihui Zhong, Peigui Gu","doi":"10.21037/jtd-2026-1437","DOIUrl":"https://doi.org/10.21037/jtd-2026-1437","url":null,"abstract":"<p><strong>Background: </strong>Adequate lymph node (LN) examination during resection of non-small cell lung cancer (NSCLC) underpins accurate staging, but the number of examined lymph nodes (ELNs) beyond which additional retrieval confers no further benefit remains uncertain, and it is not known whether any single threshold applies across nodal stages. This study aims to systematically examine the association between ELN count, staging migration, and long-term survival to identify an evidence-based optimal ELN threshold.</p><p><strong>Methods: </strong>We analysed 61,994 patients undergoing resection for NSCLC in the program (SEER) 17 registry (2010-2019). The detection of nodal metastasis was assessed as the proportion of node-positive cases and the mean number of positive nodes across ELN categories. Non-linearity was examined with restricted cubic splines. A threshold of 16 nodes, proposed in earlier work, was pre-specified and tested using a two-piecewise Cox model rather than derived from these data; the analysis was repeated across candidate breakpoints from 10 to 30 and separately by pathological N stage and extent of resection. Internal validation used split-sample and bootstrap resampling.</p><p><strong>Results: </strong>The median ELN count was 9 (interquartile range, 5-15). Regression analyses included the 59,961 patients with 1 to 30 nodes examined, among whom 18,849 deaths occurred. After full adjustment, each increment of 5 ELNs was associated with higher odds of node-positive disease [odds ratio (OR) 1.19; 95% confidence interval (CI): 1.17-1.22] and lower mortality [hazard ratio (HR) 0.94; 95% CI: 0.92-0.95]. Below 16 nodes, each additional node was associated with a 2.1% reduction in the hazard of death (HR 0.979; 95% CI: 0.976-0.983; P<0.001), whereas above 16 no association was detectable (HR 1.001; 95% CI: 0.994-1.007; P=0.88); the two slopes differed significantly (P<0.001). No association above the breakpoint was found at any candidate value from 12 nodes upwards. On stratified analysis the two-piecewise model improved fit only in node-negative disease (P<0.001) and only after lobectomy (P<0.001); among node-positive patients the association persisted across the full range without a plateau (P=0.32).</p><p><strong>Conclusions: </strong>In node-negative NSCLC treated by anatomical resection, the survival benefit of additional nodal retrieval attenuates beyond approximately 16 examined nodes, and this count may serve as a practical benchmark for auditing the adequacy of nodal examination. No comparable ceiling was identified in node-positive disease, in which more extensive retrieval remained associated with lower mortality. As an observational registry analysis, these findings describe associations rather than causal effects.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1006"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical resection for indeterminate pulmonary nodules in patients with prior breast cancer: diagnostic value and biomarker reassessment.","authors":"Yoshiko Masuda, Shuko Ono, Masumi Tanaka, So Miyahara, Keita Tokuishi, Yasuteru Yoshinaga, Toshihiko Sato","doi":"10.21037/jtd-2026-1302","DOIUrl":"https://doi.org/10.21037/jtd-2026-1302","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary nodules detected during postoperative surveillance in breast cancer survivors present a diagnostic challenge because imaging findings alone often cannot reliably distinguish pulmonary metastases from primary lung cancer. Surgical resection provides definitive pathological diagnosis while simultaneously enabling biomarker reassessment in metastatic lesions. This study evaluated the diagnostic value and clinical significance of pulmonary resection for indeterminate pulmonary nodules in patients with prior breast cancer.</p><p><strong>Methods: </strong>We retrospectively reviewed 33 pulmonary resections performed in 32 consecutive patients with a history of breast cancer who underwent pulmonary resection for indeterminate pulmonary nodules between 2016 and 2025. Clinicopathological findings, imaging characteristics, perioperative outcomes, and receptor discordance between primary breast tumors and pulmonary metastatic lesions were analyzed. Paired biomarker data were available for 18 patients with pulmonary metastases.</p><p><strong>Results: </strong>Final pathological diagnoses included metastatic breast cancer in 23 lesions (69.7%), primary lung cancer in 9 lesions (27.3%), and benign disease in 1 lesion (3.0%), indicating that more than one-quarter of lesions suspected preoperatively to represent pulmonary metastases were actually primary lung cancers. Most procedures were performed using video-assisted thoracoscopic surgery (87.9%). Among patients with paired biomarker data, substantial discordance in hormone receptor and human epidermal growth factor receptor 2 (HER2) expression was observed, including frequent conversion between HER2-0 and HER2-low categories. Biomarker reassessment resulted in modification of subsequent systemic treatment in three patients. Perioperative outcomes were favorable, with no operative mortality and low postoperative morbidity.</p><p><strong>Conclusions: </strong>Surgical resection for indeterminate pulmonary nodules in selected patients with prior breast cancer provides definitive pathological diagnosis, appropriate local treatment, and sufficient tissue for biomarker reassessment. Histological confirmation should be considered when imaging findings remain inconclusive because pulmonary nodules in breast cancer survivors are not necessarily metastatic disease. Biomarker reassessment may directly influence individualized systemic treatment strategies in the HER2-low era.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1046"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sonographic target characterization in single-pass endobronchial ultrasound-guided transbronchial needle aspiration.","authors":"Dan Mao, Tao Yu","doi":"10.21037/jtd-2026-2144","DOIUrl":"https://doi.org/10.21037/jtd-2026-2144","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1068"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of the triglyceride-glucose index and triglyceride-glucose-body mass index with postoperative atrial fibrillation in patients undergoing off-pump coronary artery bypass grafting: a retrospective cohort study.","authors":"Zhiyuan Song, Jiawei Wu, Ze Bu, Jiangpeng Li, Shuhao Li, Yang Wang, Zongtao Yin, Jian Zhang, Huishan Wang","doi":"10.21037/jtd-2026-1640","DOIUrl":"https://doi.org/10.21037/jtd-2026-1640","url":null,"abstract":"<p><strong>Background: </strong>Postoperative atrial fibrillation (POAF) is a common complication following off-pump coronary artery bypass grafting (OPCABG). Insulin resistance (IR) contributes to the pathogenesis of POAF. IR-related markers, including the triglyceride-glucose (TyG) index and the triglyceride-glucose-body mass index (TyG-BMI), have demonstrated prognostic value for cardiovascular events. However, their associations with POAF specifically after OPCABG remain unclear. This study aimed to evaluate the associations of TyG and TyG-BMI with POAF and their incremental value beyond conventional clinical risk factors.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort study of adult patients who underwent isolated OPCABG between December 2020 and December 2021. Of 757 otherwise eligible patients, 93 without the preoperative fasting glucose and/or triglyceride measurements required to calculate the indices were excluded, leaving 664 participants in the primary analysis. Multivariable logistic regression, restricted cubic spline (RCS), discrimination and reclassification analyses, and bootstrap internal validation were performed.</p><p><strong>Results: </strong>Of the 664 participants, 180 (27.1%) developed POAF. In the fully adjusted model, each standard deviation increase in TyG and TyG-BMI was associated with higher odds of POAF [TyG: odds ratio (OR), 1.55; 95% confidence interval (CI): 1.28-1.89; TyG-BMI: OR, 1.60; 95% CI: 1.31-1.96; both P<0.001]. RCS analysis showed an approximately linear association for TyG (P for nonlinearity =0.16) and a nonlinear association for TyG-BMI (P for nonlinearity =0.02). Adding TyG or TyG-BMI to the baseline model increased the C-statistic from 0.682 to 0.708 or 0.707, respectively, although the changes were not statistically significant (P=0.07 and P=0.08). Both indices improved the integrated discrimination improvement (IDI) and continuous net reclassification improvement (NRI) (all P<0.001). Associations were stronger among patients with diabetes (P for interaction =0.02 for TyG and 0.005 for TyG-BMI).</p><p><strong>Conclusions: </strong>Higher preoperative TyG and TyG-BMI values were independently associated with POAF after OPCABG. These routinely available indices provided modest incremental risk information beyond conventional clinical risk factors. External validation is required before their use for clinical decision-making.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1033"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The seduction of the target: individualized hemodynamics and the limits of precision care after esophagectomy.","authors":"Laurence Weinberg","doi":"10.21037/jtd-2026-1997","DOIUrl":"https://doi.org/10.21037/jtd-2026-1997","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1074"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of synergistic trajectories between early mobilization potential and actual implementation with clinical outcomes among ICU patients with pneumonia: a multivariate latent class mixed model analysis.","authors":"Xiaohong Zhu, Yuxuan Zhou","doi":"10.21037/jtd-2026-0939","DOIUrl":"https://doi.org/10.21037/jtd-2026-0939","url":null,"abstract":"<p><strong>Background: </strong>Although early mobilization is a key intervention in the management of patients admitted to the intensive care unit (ICU), its effects on patients remain controversial in previous studies. This study aimed to explore the synergistic trajectories of early mobilization potential and actual implementation in ICU patients with pneumonia and their impacts on clinical outcomes.</p><p><strong>Methods: </strong>Data were extracted from the Medical Information Mart for Intensive Care (MIMIC) database. Multivariate latent class mixed model (MLCMM) was adopted to identify mobilization trajectories within the first 72 hours of ICU admission among patients with pneumonia and perform subgroup stratification. Linear regression analysis was applied to investigate the association between early mobilization and length of stay (LOS) in the ICU across each subgroup. Subgroup analyses were conducted to explore the heterogeneity of the above association in populations with different characteristics. Kaplan-Meier curves were used to depict survival disparities, and Sankey diagrams were applied to illustrate discharge destinations.</p><p><strong>Results: </strong>A total of 3,226 patients with pneumonia were included. In the fully adjusted model, Class 2 showed no statistically significant difference in ICU LOS relative to Class 1 [β=-0.04, 95% confidence interval (CI): -0.11 to 0.04, P=0.35]. Class 3 (β=-0.43, 95% CI: -0.51 to -0.35, P<0.001) and Class 4 (β=-0.42, 95% CI: -0.50 to -0.33, P<0.001) were associated with shorter ICU LOS. Sensitivity analyses yielded results consistent with the primary analysis. Significant interaction effects were observed in the subgroups of age (P for interaction =0.01) and mechanical ventilation (P for interaction <0.001) on the above association. Compared with Class 1, the other three subgroups were associated with higher survival probabilities (log-rank P<0.001). The Sankey diagram revealed that Class 1 was characterized by adverse clinical prognoses.</p><p><strong>Conclusions: </strong>This study demonstrates that low-level stable early mobilization is associated with longer ICU LOS and lower survival rate in patients with pneumonia. These findings suggest that distinct mobilization trajectories may reflect patients' early recovery status.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1035"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond bar configuration: redefining pectus excavatum repair from deformity correction to complete chest wall remodeling.","authors":"Chiel J Franssen, Jean H T Daemen, Elise J van Polen, Philippe J M Pinckaers, Dawn Jaroszewski, Lisa E McMahon, Marcelo Martinez-Ferro, Manuel López, Joel Dunning, Karel W E Hulsewé, Yvonne L J Vissers, Erik R de Loos","doi":"10.21037/jtd-2026-2554","DOIUrl":"https://doi.org/10.21037/jtd-2026-2554","url":null,"abstract":"","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1005"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External validation of the eurolung risk model for morbidity using an institutional database on minimally invasive major lung resections.","authors":"Ruoyu Zhang, Danjouma Cheufou","doi":"10.21037/jtd-2026-0821","DOIUrl":"https://doi.org/10.21037/jtd-2026-0821","url":null,"abstract":"<p><strong>Background: </strong>The EuroLung1 model was developed by the European Society of Thoracic Surgeons (ESTS) to estimate the risk of major cardiopulmonary complications after anatomical lung resection. Because minimally invasive approaches were underrepresented in the original derivation cohort, its performance in contemporary thoracoscopic practice remains uncertain. We therefore conducted an external validation using a cohort of patients undergoing minimally invasive major lung resection.</p><p><strong>Methods: </strong>This retrospective study included 644 consecutive patients (293 females and 351 males; median age, 66 years) treated with thoracoscopic lobectomy or segmentectomy. For each patient, the EuroLung1 score was determined according to the published scoring algorithm incorporating eight weighted clinical and operative variables. Patients were subsequently categorized into the predefined risk classes. Associations between the score and major morbidity were examined, while model discrimination and calibration were evaluated using standard validation metrics.</p><p><strong>Results: </strong>The cohort included 574 lobectomies (89.1%) and 70 segmentectomies (10.9%). Histopathology revealed 548 patients (85.1%) with confirmed non-small cell lung cancer (NSCLC), 66 (10.2%) with benign disease, and 30 (4.7%) with pulmonary metastasis. Postoperative mortality and major complication rates were 0.9% and 12.9%, respectively. In logistic regression analysis, each 1-point increase in the EuroLung1 score was associated with 9% higher odds of morbidity [odds ratio (OR) =1.092, 95% confidence interval (CI): 1.010-1.180, P=0.03]. Similarly, advancing by one risk class conferred a 33% increase in the odds (OR =1.327, 95% CI: 1.027-1.715, P=0.03). Calibration analysis revealed that the EuroLung1 score underestimated morbidity risk in lower-risk classes and overestimated it in higher-risk classes. Discrimination performance of EuroLung1 score was poor, with an area under the receiver operating characteristic (ROC) curve of 0.573.</p><p><strong>Conclusions: </strong>Although the EuroLung1 score retained a significant relationship with postoperative major morbidity after minimally invasive anatomical lung resection, its predictive performance was suboptimal. The weak discrimination and variable calibration observed in this validation cohort suggest that model recalibration or revision may be necessary before application to individual risk estimation in contemporary minimally invasive thoracic surgery.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":"18 9","pages":"1047"},"PeriodicalIF":2.3,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}