{"title":"The Efficacy and Safety of NOAC in Very Elderly Atrial Fibrillation Patients: Data From the Korean National Health Insurance Cohort Registry.","authors":"Seong Huan Choi, Yeong Chan Lee, Yong-Soo Baek","doi":"10.4070/kcj.2024.0073","DOIUrl":"10.4070/kcj.2024.0073","url":null,"abstract":"<p><strong>Background and objectives: </strong>We investigated the clinical benefit of anticoagulation with non-vitamin K antagonist oral anticoagulant (NOAC) in very elderly atrial fibrillation (AF) patients through national healthcare insurance registry.</p><p><strong>Methods: </strong>Clinical data was acquired from the National Health Insurance Service of south Korea. Medical records of 862,935 patients who were diagnosed with AF from 2015 to 2020 were collected for analysis. Patients under the age of 85, prior history of intracranial hemorrhage, gastrointestinal bleeding and prior prescription days of aspirin, warfarin or NOAC exceeding 90 along with follow up period less than 90 days were excluded.</p><p><strong>Results: </strong>A total of 10,625 patients were eligible for analysis. Patients with oral anticoagulant (hazard ratio [HR], 0.60, 95% confidence interval [CI], 0.53-0.69, p<0.001) showed higher efficacy regarding cerebrovascular accident (CVA) compared to aspirin (HR, 0.84, 95% CI, 0.74-0.95, p=0.008) and no treatment group. Individual comparison of NOAC and aspirin via propensity score matching showed that patients with NOAC (HR, 0.71, 95% CI, 0.61-0.85, p<0.001) showed higher event free survival regarding CVA compared to aspirin. Bleeding risk was also higher for NOAC (HR, 1.28, 95% CI, 1.07-1.56, p=0.006) group but did not result in commensurate increase in mortality (HR, 0.60, 95% CI, 0.45-0.81, p<0.001).</p><p><strong>Conclusions: </strong>Anticoagulation with NOAC in very elderly patient showed higher event free survival regarding CVA. Despite having higher event rate of bleeding, eventual death was lower for NOAC.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":"811-821"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11685351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468964","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":"Escalating Lipid Therapy After Achieving LDL-C <70 mg/dL With Moderate-Intensity Statins in High-Risk Patients.","authors":"Geunhee Park, Eui-Young Choi, Sang-Hak Lee","doi":"10.4070/kcj.2024.0218","DOIUrl":"https://doi.org/10.4070/kcj.2024.0218","url":null,"abstract":"<p><strong>Background and objectives: </strong>Guidelines recommend target levels of low-density lipoprotein cholesterol (LDL-C) and intensive lipid-lowering therapy (LLT) in high-risk patients. However, the value of escalating LLT when the LDL-C targets are achieved with moderate-intensity statins is unknown. We aimed to evaluate the benefits of LLT escalation in this population.</p><p><strong>Methods: </strong>In this retrospective propensity score-matched study, we screened data from two university hospitals between 2006 and 2021. Of the 54,069 patients with atherosclerotic cardiovascular disease (ASCVD), 3,205 who achieved LDL-C levels <70 mg/dL with moderate-intensity statins were included. After 1:3 matching, 1,315 patients (339 with LLT escalation and 976 without) were ultimately examined. The primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE)1 (cardiovascular death, nonfatal myocardial infarction, and nonfatal ischemic stroke) and all-cause death.</p><p><strong>Results: </strong>During a median follow-up of 5.7 years, the MACCE1 rate was not significantly lower in the escalation group than in the non-escalation group (9.8 and 14.3/1,000 person-years, respectively; hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.43-1.09; p=0.11). Kaplan-Meier curves showed similar results (log-rank p=0.11). The risk of all-cause death did not differ between the groups. MACCE2 rate, which additionally includes coronary/peripheral revascularization, was lower in the escalation group (24.5 and 35.4/1,000 person-years, respectively; HR, 0.70; 95% CI, 0.52-0.94; p=0.017).</p><p><strong>Conclusions: </strong>LLT escalation did not significantly lower hard cardiovascular outcomes and all-cause death in patients with ASCVD achieving LDL-C levels <70 mg/dL with moderate-intensity statins. However, it had benefit in reducing revascularization rates in this population.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902854","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}
Peijian Wei, Yihang Li, Liang Xu, Junyi Wan, Fengwen Zhang, Gary Tse, Jeffrey Shi Kai Chan, Shouzheng Wang, Wenbin Ouyang, Gejun Zhang, Fang Fang, Xiangbin Pan
{"title":"Comparison of Embolization Coils and Patent Ductus Arteriosus Occluders for Coronary Artery Fistula Transcatheter Closure: A Single Centre Experience.","authors":"Peijian Wei, Yihang Li, Liang Xu, Junyi Wan, Fengwen Zhang, Gary Tse, Jeffrey Shi Kai Chan, Shouzheng Wang, Wenbin Ouyang, Gejun Zhang, Fang Fang, Xiangbin Pan","doi":"10.4070/kcj.2024.0202","DOIUrl":"https://doi.org/10.4070/kcj.2024.0202","url":null,"abstract":"<p><strong>Background and objectives: </strong>There is no dedicated occlusive device for closing coronary artery fistulas (CAFs), and specific efficacy and safety data of various off-label occlusive devices for CAFs closure are scarce.</p><p><strong>Methods: </strong>Patients undergoing transcatheter closure of CAFs from January 2011 to December 2022 were included in the single-center retrospective study. The study population was divided into 2 groups: coils group (n=35) and patent ductus arteriosus (PDA) occluders group (n=66).</p><p><strong>Results: </strong>No significant intergroup differences were observed in demographic characteristics except age. The presence of multiple CAF origins (54.3% vs. 4.5%, p<0.001) and multiple draining sites (51.4% vs. 3.0%, p<0.001) were more common in the coils group. In contrast, the presence of aneurysm (72.7% vs. 14.3%, p<0.001), and large fistula (75.8% vs. 37.1%, p<0.001) were more prevalent in the PDA occluders group. The acute procedural success rate of the PDA occluders group was higher compared to that of the coils group (87.9% vs. 62.9%, adjusted odds ratio [OR], 7.20; 95% confidence interval, 1.59-32.64; p=0.01). In addition, no significant intergroup differences were noted in both the recanalization rate (7.8% vs. 20%, p=0.107) and the reintervention rate (3.1% vs. 8.6%, p=0.342).</p><p><strong>Conclusions: </strong>Transcatheter closure of CAFs using PDA occluders was associated with significantly higher acute procedural success rates compared to coil embolization with comparable late outcomes.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903320","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}
Ping Li, Feng Wang, Anna Yue, Yanling Xuan, Ying Huang, Jingyi Xu, Jiayi Weng, Yuan Li, Kangyun Sun
{"title":"LncRNA uc003pxg.1 Interacts With miR-339-5p Promote Vascular Endothelial Cell Proliferation, Migration and Angiogenesis.","authors":"Ping Li, Feng Wang, Anna Yue, Yanling Xuan, Ying Huang, Jingyi Xu, Jiayi Weng, Yuan Li, Kangyun Sun","doi":"10.4070/kcj.2024.0153","DOIUrl":"https://doi.org/10.4070/kcj.2024.0153","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study aimed to investigate the roles of lncRNA uc003pxg.1 and miR-339-5p in regulating the occurrence and development of coronary heart disease.</p><p><strong>Methods: </strong>First, the expression levels of uc003pxg.1 and miR-339-5p were verified in peripheral blood mononuclear cells of clinical samples. Then, the target gene was identified using high-throughput sequencing combined with bioinformatics. Human umbilical vein endothelial cells (HUVECs) were transfected with si-uc003pxg.1, miR-339-5p mimic and miR-339-5p inhibitor, and the expression of related genes was detected by reverse transcription-quantitative polymerase chain reaction and western blotting. EdU, CCK-8, Cell scratch and Transwell assays were used to analyze the effects of uc003pxg.1 and miR-339-5p on cell proliferation and migration.</p><p><strong>Results: </strong>The expression of uc003pxg.1 and miR-339-5p was negatively correlated in clinical samples and HUVECs. The si-uc003pxg.1 and miR-339-5p mimic decreased the proliferation and migration of HUVECs and decreased the expression of transforming growth factor (TGF)-β1 and α-smooth muscle actin (SMA). The protein expression levels of TGF-β1, α-SMA, CD31, collagen I, collagen III and endoglin were decreased, and angiogenesis was weakened. The miR-339-5p inhibitor had the opposite effect.</p><p><strong>Conclusions: </strong>Our study revealed that upregulation of uc003pxg.1 and downregulation of miR-339-5p in vitro promote cell proliferation, cell migration and angiogenesis and upregulate the expression of TGF-β1, α-SMA, CD31, collagen I, collagen III and endoglin, which may lead to the development of vascular atherosclerosis.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903118","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}
Joo Hee Jeong, Kyongjin Min, Jong-Il Choi, Su Jin Kim, Seung-Young Roh, Kap Su Han, Juhyun Song, Sung Woo Lee, Young-Hoon Kim
{"title":"Cardiovascular Etiologies and Risk Factors of Survival Outcomes After Resuscitation for Out-of-Hospital Cardiac Arrest: Data From the KoCARC Registry.","authors":"Joo Hee Jeong, Kyongjin Min, Jong-Il Choi, Su Jin Kim, Seung-Young Roh, Kap Su Han, Juhyun Song, Sung Woo Lee, Young-Hoon Kim","doi":"10.4070/kcj.2024.0243","DOIUrl":"https://doi.org/10.4070/kcj.2024.0243","url":null,"abstract":"<p><strong>Background and objectives: </strong>The outcomes and characteristics of out-of-hospital cardiac arrest (OHCA) vary across geographic regions. The etiologies and prognoses of OHCA in Asian populations remain less established. This study aimed to investigate the etiologies and clinical characteristics of patients successfully resuscitated after OHCA and to identify predictors of survival outcomes.</p><p><strong>Methods: </strong>Data were extracted from a South Korean multicenter prospective registry of OHCA that included 64 tertiary hospitals from 2015 to 2018 (n=7,577). The primary outcome was in-hospital mortality, and the secondary outcome was a Cerebral Performance Category (CPC) score of grade 1 at discharge.</p><p><strong>Results: </strong>Of the 7,577 patients, 2,066 achieved return of spontaneous circulation (ROSC) and were hospitalized. A total of 915 (44.2%) presented with ventricular arrhythmia (VA) as their initial rhythm or on admission. The leading cause was obstructive coronary artery disease (n=413; 20.0%). Sudden unexplained death syndrome (SUDS) accounted for 67.5% of survivors and was significantly less common in patients with VA (82.7% vs. 48.3%, p<0.001). VA was an independent predictor of in-hospital mortality (adjusted hazard ratio, 0.774; 95% confidence interval [CI], 0.633-0.946; p=0.012) and the grade-1 CPC score at discharge (odds ratio, 2.822; 95% CI, 1.909-4.172; p<0.001). Other predictors of in-hospital mortality included age, diabetes mellitus, witnessed cardiac arrest, ROSC on arrival, total arrest time, alertness on admission, extracorporeal membrane oxygenation use, targeted temperature management, and coronary reperfusion.</p><p><strong>Conclusions: </strong>SUDS was common in patients with ROSC after OHCA. VA was independently associated with favorable survival outcomes at discharge. Prompt clinical intervention may improve clinical outcomes in patients with OHCA, particularly those with VA.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903319","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}
In Tae Jin, Ji Woong Roh, Oh-Hyun Lee, Eui Im, Deok-Kyu Cho, Jun-Won Lee, Bong-Ki Lee, Sang-Yong Yoo, Sang Yeub Lee, Chan Joon Kim, Han-Young Jin, Jin Sup Park, Jung Ho Heo, Do Hoi Kim, Jin Bae Lee, Dong-Kie Kim, Jun Ho Bae, Sung-Yun Lee, Seung-Hwan Lee, Yongcheol Kim
{"title":"Feasibility of Distal Radial Access in High Bleeding Risk Patients Who Underwent Percutaneous Coronary Intervention.","authors":"In Tae Jin, Ji Woong Roh, Oh-Hyun Lee, Eui Im, Deok-Kyu Cho, Jun-Won Lee, Bong-Ki Lee, Sang-Yong Yoo, Sang Yeub Lee, Chan Joon Kim, Han-Young Jin, Jin Sup Park, Jung Ho Heo, Do Hoi Kim, Jin Bae Lee, Dong-Kie Kim, Jun Ho Bae, Sung-Yun Lee, Seung-Hwan Lee, Yongcheol Kim","doi":"10.4070/kcj.2024.0239","DOIUrl":"https://doi.org/10.4070/kcj.2024.0239","url":null,"abstract":"<p><strong>Backgrounds and objectives: </strong>The distal radial access (DRA), a potential alternative to the trans-radial approach (TRA), may offer advantages in terms of access site complications due to its smaller vessel diameter, especially for high bleeding risk (HBR) patients. This study aims to investigate the feasibility of DRA in HBR patients.</p><p><strong>Methods: </strong>Based on data from the KODRA registry, a prospective, multicenter cohort, this study analyzed 1,586 patients who underwent successful percutaneous coronary intervention (PCI) via DRA. Patients were categorized into HBR and non-HBR groups. The primary endpoint of the study is DRA-related bleeding, and the secondary endpoints of the study are overall access site complications and each component of the access site complications. To reduce the effect of potential confounders, a multivariable adjustment analysis was performed.</p><p><strong>Results: </strong>The mean age of the total population was 71.1±10.8 years, and 40.3% of patients were female. Both DRA-related bleeding (odds ratio [OR], 1.15; 95% confidence interval [CI], 0.67-1.97; p=0.616) and overall access site complications (OR, 1.08; 95% CI, 0.67-1.72; p=0.761) were not significantly different between the HBR group and non-HBR group after multivariable adjustment. No major bleeding before discharge was observed in both groups. Furthermore, the incidence of distal and conventional radial artery occlusion was less than 1% at 1-month follow-up in both groups.</p><p><strong>Conclusions: </strong>Our study results showed the safety of DRA for both DRA-related bleeding and access site complications among HBR patients who underwent PCI.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04080700.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903038","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}
Junghoon Lee, Tae Oh Kim, Pil Hyung Lee, Young-Hak Kim, Osung Kwon, Seung-Whan Lee
{"title":"Safety and Feasibility of Robot-Assisted Percutaneous Coronary Intervention Using the AVIAR 2.0 System: A Prospective, Multi-Center, Single-Arm, Open, Investigator-Initiated, Post-Approval Clinical Trial.","authors":"Junghoon Lee, Tae Oh Kim, Pil Hyung Lee, Young-Hak Kim, Osung Kwon, Seung-Whan Lee","doi":"10.4070/kcj.2024.0226","DOIUrl":"https://doi.org/10.4070/kcj.2024.0226","url":null,"abstract":"<p><strong>Background and objectives: </strong>Traditional manual percutaneous coronary intervention (PCI) exposes operators to significant radiation and physical stress. The recently developed Advanced Vascular Intervention Assist Robot (AVIAR) 2.0 system in South Korea aimed to overcome these issues by evaluating its safety and feasibility in a clinical setting.</p><p><strong>Methods: </strong>The study enrolled patients with stable angina from 2 medical centers. Single-vessel de novo lesions were treated using the AVIAR 2.0 system. The primary endpoints were technical success (using the AVIAR system for PCI devices, including guidewires, balloon catheters, and stents, without switching to manual) and clinical success (<30% residual stenosis in the treated lesion and no major cardiovascular events within 48 hours or before discharge). Secondary endpoints included operator radiation exposure and procedural time. Safety was assessed using treatment-emergent adverse events.</p><p><strong>Results: </strong>Twenty patients (mean age, 63.9±8.5 years, 70% male) underwent robot-assisted PCI for lesions mainly in the left anterior descending artery and right coronary artery, with 95% (19/20) classified as B2/C lesions. The average robotic procedural time was 23:06±05:55 minutes. Technical success was 100%, with no need for manual conversion. Clinical success was 100%, with no major complications until discharge. Operator effective radiation dose was reduced by 84% compared to table effective doses.</p><p><strong>Conclusions: </strong>The AVIAR 2.0 system appears to be a safe and effective adjunct to manual PCI, enhancing procedural efficiency and reducing operator radiation exposure. These findings support the use of robotics in coronary interventions and suggest a promising future for minimally invasive cardiac procedures.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05981859.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903152","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}
JungMin Choi, So-Young Yang, So-Ryoung Lee, Min Soo Cho, Kyung-Yeon Lee, Hyo-Jeong Ahn, Soonil Kwon, Myung-Jin Cha, Jun Kim, Gi-Byoung Nam, Kee-Joon Choi, Eue-Keun Choi, Seil Oh, Gregory Y H Lip
{"title":"Increasing Very Low-Dose Edoxaban Prescription: Effectiveness and Safety Data of Korean AF Patients.","authors":"JungMin Choi, So-Young Yang, So-Ryoung Lee, Min Soo Cho, Kyung-Yeon Lee, Hyo-Jeong Ahn, Soonil Kwon, Myung-Jin Cha, Jun Kim, Gi-Byoung Nam, Kee-Joon Choi, Eue-Keun Choi, Seil Oh, Gregory Y H Lip","doi":"10.4070/kcj.2024.0222","DOIUrl":"https://doi.org/10.4070/kcj.2024.0222","url":null,"abstract":"<p><strong>Background and objectives: </strong>Evidence remains limited on the real-world prescription of very low-dose oral anticoagulation among frail patients with atrial fibrillation (AF). We described the practice patterns, effectiveness, and safety of very low-dose edoxaban (15 mg once daily).</p><p><strong>Methods: </strong>Patients with AF prescribed edoxaban 15 mg once daily in 2 tertiary hospitals between 2016 and September 2022 were included. Baseline clinical characteristics and clinical outcomes of interest were thromboembolic and bleeding events.</p><p><strong>Results: </strong>A total of 674 patients were included (mean age 78.3±9.1, 49.7% aged ≥80 years, 49.3% women, median follow-up 1.0±1.2 years). Mean CHA₂DS₂-VASc score was 3.9±1.6, and the modified HAS-BLED score was 2.0±1.1. Between 2016 and 2022, the number of very low-dose edoxaban prescriptions increased. The main reasons for the prescription of very low-dose were low body weight (55.5% below 60 kg), anaemia (62.8%), chronic kidney disease (40.2%), active cancer (15.3%), concomitant anti-platelet use (26.7%), and prior major bleeding (19.7%). During a median follow-up duration of 8 (interquartile range 3-16) months, overall thromboembolic and bleeding events occurred in 16 (2.3%) and 88 (13.1%) patients, respectively. Compared to the expected event rates on the established risk scoring systems, patients receiving very low-dose edoxaban demonstrated a 61% reduction in ischemic stroke, a 68% reduction of ischemic stroke/transient ischemic attack/systemic embolism, whereas a 49% increase in major bleeding.</p><p><strong>Conclusions: </strong>The prescription of very low-dose edoxaban was increased over time, attributable to various clinical factors. The use of very low-dose edoxaban reduced the expected risk of thromboembolic events.</p>","PeriodicalId":17850,"journal":{"name":"Korean Circulation Journal","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729793","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}