Medical Microbiology and Immunology最新文献

{"title":"Resistance to fosfomycin is increasing and is significantly associated with extended-spectrum β-lactamase-production in urinary isolates of Escherichia coli.","authors":"Esther Ríos,&nbsp;María Del Carmen López Diaz,&nbsp;Esther Culebras,&nbsp;Iciar Rodríguez-Avial,&nbsp;Carmen Rodríguez-Avial","doi":"10.1007/s00430-022-00749-2","DOIUrl":"https://doi.org/10.1007/s00430-022-00749-2","url":null,"abstract":"<p><p>Fosfomycin has become a therapeutic option in urinary tract infections. Our objective was to evaluate the in vitro activity of fosfomycin against Escherichia coli isolated from urine samples in 2013, 2018 and 2021. We also determined a putative association between fosfomycin resistance and extended-spectrum β-lactamases (ESBL) production. Fosfomycin activity was evaluated against 7367, 8128 and 5072 Escherichia coli urinary isolates in 2013, 2018 and 2021, respectively. We compare the prevalence of fosfomycin-resistant strains among the ESBL- and non-ESBL-producing isolates. MICs of fosfomycin, cefotaxime, and cefotaxime-clavulanate were determined by a microdilution method. 302 ESBL-producers were selected to determine MICs of fosfomycin by agar dilution and genes encoding ESBLs were detected by PCR. Among the total of ESBL-producing strains, 14.3%, 20.8% and 20% were resistant to fosfomycin in 2013, 2018 and 2021, respectively, whereas fosfomycin resistance in non-ESBL producers was 3.5%, 4.05% and 5.53% for each year (P ≤ 0.001). In the 302 selected ESBL-producing isolates, CTX-M was the main ESBL (228 isolates), being 50.7% CTX-M-15. Resistance to fosfomycin among these ESBL-producing strains was associated (P = 0.049) with isolates that produced the CTX-M type. Our data show that fosfomycin resistance is increasing in Escherichia coli urinary isolates and it is related to ESBL-production. A follow-up of fosfomycin resistance is required.</p>","PeriodicalId":18369,"journal":{"name":"Medical Microbiology and Immunology","volume":"211 5-6","pages":"269-272"},"PeriodicalIF":5.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9618510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40346616","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":"Low rate of asymptomatic carriage and salivary immunoglobulin A response to Group A Streptococci in the healthy adult population in Finland.","authors":"Emilia Lönnqvist,&nbsp;Kirsi Gröndahl-Yli-Hannuksela,&nbsp;Vuokko Loimaranta,&nbsp;Jaana Vuopio","doi":"10.1007/s00430-022-00750-9","DOIUrl":"https://doi.org/10.1007/s00430-022-00750-9","url":null,"abstract":"<p><p>Streptococcus pyogenes, also called group A streptococcus (GAS), is a human pathogen causing a wide range of infections ranging from mild tonsillitis to severe, life threatening conditions such as bacteraemia, necrotizing fasciitis, and streptococcal toxic shock syndrome. GAS may also colonise the oropharynx without causing any signs of disease which is known as asymptomatic carriage. This study aims to investigate IgA responses against GAS and oral streptococci from saliva samples collected from healthy Finnish adults. In addition, asymptomatic throat GAS carriage was studied. The study participants consisted of healthy adult volunteers who provided one saliva sample, a throat swab, and a background questionnaire. Total salivary IgA, and GAS specific IgA were analysed from the saliva samples using enzyme-linked immunosorbent assays (ELISA) and the results were compared to oral streptococci specific IgA levels. Asymptomatic GAS throat carriers were identified by bacterial culture, and the isolates were emm typed. Samples from a total of 182 individuals were analysed. The median salivary IgA concentration was 62.9 µg/ml (range 17.3-649.9 µg/ml), and median GAS and oral streptococcal specific IgA concentrations 2.7 and 3.3 arbitrary units (AU, range 1.4-7.4 AU and 1.6-12.0 AU), respectively. Three individuals with asymptomatic GAS throat carriage were identified.</p>","PeriodicalId":18369,"journal":{"name":"Medical Microbiology and Immunology","volume":"211 5-6","pages":"261-267"},"PeriodicalIF":5.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9437406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40341766","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":"Immunological imbalance in microcephalic children with congenital Zika virus syndrome.","authors":"Amanda Costa Ayres Salmeron,&nbsp;Wallace Pitanga Bezerra,&nbsp;Rafaela Lúcia Lopes de Souza,&nbsp;Luanderson Cardoso Pereira,&nbsp;Lícia Maria do Nascimento,&nbsp;Anna Cláudia Calvielli Castelo Branco,&nbsp;Luiza Emilia Cavalcanti Simas,&nbsp;Valéria Azevedo de Almeida,&nbsp;Pedro Henrique de Souza Palmeira,&nbsp;Christiane Medeiros Bezerra,&nbsp;Paulo Marcos Matta Guedes,&nbsp;Maria Notomi Sato,&nbsp;Valéria Soraya de Farias Sales,&nbsp;Reginaldo Antônio de Oliveira Freitas Júnior,&nbsp;Tatjana de Souza Lima Keesen,&nbsp;Manuela Sales Lima Nascimento","doi":"10.1007/s00430-022-00746-5","DOIUrl":"https://doi.org/10.1007/s00430-022-00746-5","url":null,"abstract":"<p><p>Microcephalic children due congenital Zika virus syndrome (CZS) present neurological symptoms already well described. However, several other alterations can also be observed. Here, we aimed to evaluate the immune system of microcephaly CZS children. We showed that these patients have enlarged thymus, spleen and cervical lymph nodes, analysed by ultrasound and compared to the reference values for healthy children. In the periphery, they have an increase in eosinophil count and morphological alterations as hypersegmented neutrophils and atypical lymphocytes, even in the absence of urinary tract infections, parasitological infections or other current symptomatic infections. Microcephalic children due CZS also have high levels of IFN-γ, IL-2, IL-4, IL-5 and type I IFNs, compared to healthy controls. In addition, this population showed a deficient cellular immune memory as demonstrated by the low reactivity to the tuberculin skin test even though they had been vaccinated with BCG less than 2 years before the challenge with the PPD. Together, our data demonstrate for the first time that CZS can cause alterations in primary and secondary lymphoid organs and also alters the morphology and functionality of the immune system cells, which broadens the spectrum of CZS symptoms. This knowledge may assist the development of specific therapeutic and more efficient vaccination schemes for this population of patients.</p>","PeriodicalId":18369,"journal":{"name":"Medical Microbiology and Immunology","volume":"211 5-6","pages":"219-235"},"PeriodicalIF":5.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40538518","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":"Human cytomegalovirus (HCMV) long-term shedding and HCMV-specific immune response in pregnant women with primary HCMV infection.","authors":"C Fornara,&nbsp;F Zavaglio,&nbsp;M Furione,&nbsp;A Sarasini,&nbsp;P d'Angelo,&nbsp;A Arossa,&nbsp;A Spinillo,&nbsp;D Lilleri,&nbsp;F Baldanti","doi":"10.1007/s00430-022-00747-4","DOIUrl":"https://doi.org/10.1007/s00430-022-00747-4","url":null,"abstract":"<p><p>Human cytomegalovirus (HCMV) shedding has been extensively investigated in newborns and in young children, however, much less is known about it in immunocompetent adults. Shedding of HCMV was investigated in saliva, vaginal secretions and urine of pregnant women experiencing primary infection along with the development of the HCMV-specific immune response. Thirty-three pregnant women shed HCMV DNA in peripheral biological fluids at least until one year after onset of infection, while in blood HCMV DNA was cleared earlier. Significantly higher levels of viral load were found in vaginal secretions compared to saliva and urine. All subjects examined two years after the onset of infection showed a high avidity index, with IgM persisting in 36% of women. Viral load in blood was directly correlated with levels of HCMV-specific IgM and inversely correlated with levels of IgG specific for the pentameric complex gH/gL/pUL128L; in addition, viral load in blood was inversely correlated with percentage of HCMV-specific CD4⁺ and CD8⁺ expressing IL-7R (long-term memory, LTM) while viral load in biological fluids was inversely correlated with percentage of HCMV-specific CD4⁺ and CD8⁺ effector memory RA⁺(T_EMRA). In conclusion, viral shedding during primary infection in pregnancy persists in peripheral biological fluids for at least one year and the development of both antibodies (including those directed toward the pentameric complex) and memory T cells are associated with viral clearance.</p>","PeriodicalId":18369,"journal":{"name":"Medical Microbiology and Immunology","volume":"211 5-6","pages":"249-260"},"PeriodicalIF":5.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40624151","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":"Changes in circulating TCF1- and GARP-associated regulatory T cell subsets reflect the clinical status of patients with chronic HBV infection.","authors":"Ayibaota Bahabayi,&nbsp;Xingyue Zeng,&nbsp;Bulidierxin Tuerhanbayi,&nbsp;Yangyang Zhang,&nbsp;Ainizati Hasimu,&nbsp;Siyu Guo,&nbsp;Tianci Liu,&nbsp;Mohan Zheng,&nbsp;Xiayidan Alimu,&nbsp;Chen Liu","doi":"10.1007/s00430-022-00748-3","DOIUrl":"https://doi.org/10.1007/s00430-022-00748-3","url":null,"abstract":"<p><p>This study aimed to clarify the expression changes and clinical significance of regulatory T (Treg) cells and follicular regulatory T (TFR) cell subsets divided by glycoprotein A repetitions predominant protein (GARP) and T cell factor 1(TCF1) in peripheral blood of patients with chronic HBV infection. The peripheral blood of 26 chronic hepatitis B (CHB) patients, 27 inactive HBsAg carriers and 32 healthy controls were collected and GARP + percentages in Treg and TFR cells were analyzed by flow cytometry. In addition, Treg and TFR cell subsets sorted by CD62L and TCF1 were analyzed and compared. Correlation analyses were performed between Treg and TFR cell subpopulations and clinical parameters as well as cytokine concentrations, including IL-21, IL-10 and TGF-β1 in plasma. Circulating Treg and TFR levels were elevated in CHB patients. Moreover, GARP and TCF1 were up-regulated in circulating Treg and TFR cells of CHB patients. TCF1 + CD62L- Treg cells were increased while TCF1-CD62L + Treg cells were decreased in CHB patients. TCF1 + CD62L- and TCF1-CD62L- TFR cells were increased while TCF1 + CD62L + TFR cells were decreased in CHB patients. TCF1 + CD62L- Treg cells were positively correlated with HBV DNA, ALT and plasma IL-10, while TCF1 + CD62L + TFR cells were negatively correlated with HBV DNA, HBeAg, HBsAg, ALT, AST, T-BIL and positively correlated with plasma IL-21. Treg and TFR subsets sorted by TCF1, CD62L and GARP were changed in CHB patients. Changes in Treg and TFR functional subsets are associated with antiviral immunity in CHB patients.</p>","PeriodicalId":18369,"journal":{"name":"Medical Microbiology and Immunology","volume":"211 5-6","pages":"237-247"},"PeriodicalIF":5.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40687435","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":"Obituary Prof. Ulrich Vogel, MD 1964-2022: a scientific mentor and expert in infection prevention and control.","authors":"Oliver Kurzai, Heike Claus, Thien-Trí Lâm","doi":"10.1007/s00430-022-00751-8","DOIUrl":"10.1007/s00430-022-00751-8","url":null,"abstract":"","PeriodicalId":18369,"journal":{"name":"Medical Microbiology and Immunology","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9630814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40452253","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":"Schistosoma mansoni infection decreases IL-33-mRNA expression and increases CXCL9 and CXCL10 production by peripheral blood cells.","authors":"Wheverton Ricardo Correia do Nascimento,&nbsp;Cassia Giselle de Oliveira Nóbrega,&nbsp;Erica de Souza Fernandes,&nbsp;Patrícia d'Emery Alves Santos,&nbsp;Fábio Lopes Melo,&nbsp;Mônica Camelo Pessôa de Azevedo Albuquerque,&nbsp;Virgínia Maria Barros de Lorena,&nbsp;Vláudia Maria Assis Costa,&nbsp;Constança Clara Gayoso Simões Barbosa,&nbsp;Valdênia Maria Oliveira de Souza","doi":"10.1007/s00430-022-00745-6","DOIUrl":"https://doi.org/10.1007/s00430-022-00745-6","url":null,"abstract":"<p><p>Schistosoma mansoni infections, particularly egg antigens, induce Th2-dominant granulomatous responses accompanied by remarkable immunoregulatory mechanisms that avoid intense fibrosis. Interleukin (IL)-33 is a cytokine that stimulates the early activation of Th2 responses, and its soluble ST2 receptor (sST2) avoids granulomatous response, as well as CXCL9 and CXCL10 chemokines that have antifibrotic activity. However, in schistosomiasis, these molecules have not been suitably studied. Therefore, this study aimed to measure IL-33 and sST2 RNA, cytokines, and chemokines in peripheral blood cultures from individuals living in schistosomiasis-endemic areas. Peripheral blood cells from individuals with S. mansoni (n = 34) and non-infected individuals (n = 31) were cultured under mitogen stimulation. Supernatant chemokines and cytokines were evaluated using a cytometric bead array, and IL-33 and sST2 mRNA expression was measured using qPCR. Infected individuals showed higher levels of CXCL8, CXCL9, CXCL10, IFN-γ, TNF-α, IL-6, IL-2, IL-4, and IL-10; there was a lower expression of IL-33 mRNA and similar expression of sST2mRNA in infected than non-infected individuals. In conclusion, for the first time, we demonstrated lower IL-33mRNA expression and high levels of the antifibrotic chemokines CXCL9 and CXCL10 in schistosomiasis mansoni, which could control exacerbations of the disease in individuals from endemic areas.</p>","PeriodicalId":18369,"journal":{"name":"Medical Microbiology and Immunology","volume":" ","pages":"211-218"},"PeriodicalIF":5.4,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40596016","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":"SARS-CoV-2 herd immunity of the Kyrgyz population in 2021.","authors":"Anna Y Popova,&nbsp;Omor T Kasymov,&nbsp;Vyacheslav Y Smolenski,&nbsp;Vyacheslav S Smirnov,&nbsp;Svetlana A Egorova,&nbsp;Zuridin S Nurmatov,&nbsp;Anzhelika M Milichkina,&nbsp;Gulmira S Suranbaeva,&nbsp;Tatiana E Kuchuk,&nbsp;Irina V Khamitova,&nbsp;Elena V Zueva,&nbsp;Valery A Ivanov,&nbsp;Zhanylai N Nuridinova,&nbsp;Aisuluu A Derkenbaeva,&nbsp;Victoria G Drobyshevskaya,&nbsp;Gulsun Z Sattarova,&nbsp;Marat T Kaliev,&nbsp;Alexandra V Gubanova,&nbsp;Oyuna B Zhimbaeva,&nbsp;Alexandra P Razumovskaya,&nbsp;Vyacheslav N Verbov,&nbsp;Ivan V Likhachev,&nbsp;Alexey V Krasnov,&nbsp;Areg A Totolian","doi":"10.1007/s00430-022-00744-7","DOIUrl":"https://doi.org/10.1007/s00430-022-00744-7","url":null,"abstract":"<p><p>In the fight against coronavirus infection, control of the immune response is of decisive importance, an important component of which is the seroprevalence of antibodies to SARS-CoV-2. Immunity to SARS-CoV-2 is formed either naturally or artificially through vaccination. The purpose of this study was to assess the seroprevalence of antibodies to SARS-CoV-2 in the population of Kyrgyzstan. A cross-sectional randomized study of seroprevalence was carried out according to a program developed by Rospotrebnadzor and the St. Petersburg Pasteur Institute, taking into account WHO recommendations. The ethics committees of the Association of Preventive Medicine (Kyrgyzstan) and the St. Petersburg Pasteur Institute (Russia) approved the study. Volunteers (9471) were recruited, representing 0.15% (95% CI 0.14-0.15) of the total population, randomized by age and region. Plasma antibodies (Abs) to the nucleocapsid antigen (Nag) were determined. In vaccinated individuals, Abs to the SARS-CoV-2 receptor-binding domain antigen (RBDag) were determined. Differences were considered statistically significant at p < 0.05. The SARS-CoV-2 Nag Ab seroprevalence was 48.7% (95% CI 47.7-49.7), with a maximum in the 60-69 age group [59.2% (95% CI 56.6-61.7)] and a minimum in group 1-17 years old [32.7% (95 CI: 29.4-36.1)]. The highest proportion of seropositive individuals was in the Naryn region [53.3% (95% CI 49.8-56.8)]. The lowest share was in Osh City [38.1% (95% CI 32.6-43.9)]. The maximum SARS-CoV-2 Nag seropositivity was found in the health-care sector [57.1% (95% CI 55.4-58.8)]; the minimum was seen among artists [38.6% (95% CI 26.0-52.4)]. Asymptomatic SARS-CoV-2 Nag seropositivity was 77.1% (95% CI 75.6-78.5). Vaccination with Sputnik V or Sinopharm produced comparable Ab seroprevalence. SARS-CoV-2 Nag seropositivity in the Kyrgyz population was 48.75% (95% CI 47.7-49.7), with the mass vaccination campaign undoubtedly benefitting the overall situation.</p>","PeriodicalId":18369,"journal":{"name":"Medical Microbiology and Immunology","volume":" ","pages":"195-210"},"PeriodicalIF":5.4,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40556881","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":"Mitochondria: intracellular sentinels of infections.","authors":"Dominik Brokatzky,&nbsp;Georg Häcker","doi":"10.1007/s00430-022-00742-9","DOIUrl":"https://doi.org/10.1007/s00430-022-00742-9","url":null,"abstract":"<p><p>Structure and integrity of the mitochondrial network play important roles in many cellular processes. Loss of integrity can lead to the activation of a variety of signalling pathways and affect the cell's response to infections. The activation of such mitochondria-mediated cellular responses has implications for infection recognition, signal transduction and pathogen control. Although we have a basic understanding of mitochondrial factors such as mitochondrial DNA or RNA that may be involved in processes like pro-inflammatory signalling, the diverse roles of mitochondria in host defence remain unclear. Here we will first summarise the functions of mitochondria in the host cell and provide an overview of the major known mitochondrial stress responses. We will then present recent studies that have contributed to the understanding of the role of mitochondria in infectious diseases and highlight a number of recently investigated models of bacterial and viral infections.</p>","PeriodicalId":18369,"journal":{"name":"Medical Microbiology and Immunology","volume":" ","pages":"161-172"},"PeriodicalIF":5.4,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9255486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40473891","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":"Child type 1 diabetes associated with mother vaginal bacteriome and mycobiome","authors":"A. Ruotsalainen, M. Tejesvi, P. Vänni, M. Suokas, P. Tossavainen, A. Pirttilä, A. Talvensaari‐Mattila, R. Nissi","doi":"10.1007/s00430-022-00741-w","DOIUrl":"https://doi.org/10.1007/s00430-022-00741-w","url":null,"abstract":"","PeriodicalId":18369,"journal":{"name":"Medical Microbiology and Immunology","volume":"42 2 1","pages":"185 - 194"},"PeriodicalIF":5.4,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77796366","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}