Menopause: The Journal of The North American Menopause Society最新文献

{"title":"Assessing cardiovascular health across the menopause transition.","authors":"Matthew Nudy, Cynthia H Chuang","doi":"10.1097/GME.0000000000002626","DOIUrl":"10.1097/GME.0000000000002626","url":null,"abstract":"","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"675-676"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The uterus is an end organ: a preliminary study of the association between abnormal uterine bleeding and hyperinsulinemia.","authors":"Andrea C Salcedo, Lani Fox, Gabriela De Los Santos, Stephanie Larson, Jane Yun","doi":"10.1097/GME.0000000000002548","DOIUrl":"10.1097/GME.0000000000002548","url":null,"abstract":"<p><strong>Objective: </strong>This preliminary study aimed to conduct initial, exploratory analyses of the association between hyperinsulinemia and biomarkers of metabolic syndrome in reproductive-aged women with abnormal uterine bleeding (AUB), with the goal of motivating future hypothesis-driven research.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from June 2019 to August 2023 at a single institution's outpatient gynecology clinics. A total of 205 premenopausal women aged 18-54 were enrolled, including 116 with AUB and 89 with normal menstrual cycles. Participants underwent fasting insulin assessment with additional markers of metabolic syndrome, including body mass index (BMI), high-density lipoprotein, and waist-to-hip ratio. Logistic regression was used to examine the association between hyperinsulinemia and AUB, adjusting for confounders such as age, race, and low-density lipoprotein. Model selection prioritized low Akaike Information Criterion and model parsimony.</p><p><strong>Results: </strong>Hyperinsulinemia was a significant predictor of AUB (OR=3.009, 95% CI: 1.372-6.832; P =0.0085). Including BMI in the model diminished the significance of hyperinsulinemia, suggesting overlapping or mediating pathways. The final model which included age, race, low-density lipoprotein, and waist-to-hip ratio achieved 73% concordance and improved model fit.</p><p><strong>Conclusion: </strong>This study highlights an association between hyperinsulinemia and AUB, with BMI playing a unique role in this relationship. These exploratory findings underscore the need for larger, longitudinal studies to clarify causal mechanisms and evaluate the potential of addressing hyperinsulinemia and BMI as part of AUB prevention and treatment strategies. Limitations, including small sample size and cross-sectional design, should be considered when interpreting these results.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"719-726"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216308","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":"Engagement with patients' sexual problems: a comparative study among general practitioners and obstetrician-gynecologists.","authors":"Anna Aromaa, Katja Kero, Sanna-Mari Manninen, Tero Vahlberg, Päivi Polo-Kantola","doi":"10.1097/GME.0000000000002551","DOIUrl":"10.1097/GME.0000000000002551","url":null,"abstract":"<p><strong>Objectives: </strong>Even though good sexual health is an important part of well-being, the evaluation of patients' sexual problems is not necessarily routine for physicians. We compared engagement (attitudes, barriers to bringing up, and practice patterns) with patients' sexual problems among general practitioners (GPs) and obstetrician-gynecologists (OB/GYNs) with special regard for the sex and age of the physician.</p><p><strong>Methods: </strong>A web-based questionnaire was used for data collection from 2 samples of physicians. The completed questionnaires from 402 GPs and 299 OB/GYNs were eligible for analysis. In the statistical analysis, the GPs were compared with the OB/GYNs as entire groups with multivariable binary logistic regression adjusted for sex and age. In addition, interaction and subgroup analysis by sex and age groups were both carried out.</p><p><strong>Results: </strong>Both GPs and OB/GYNs considered treating sexual problems to be an important health care practice. However, compared with the OB/GYNs, the GPs were less likely to inquire about sexual problems during general medical history-taking [adjusted odds ratio (aOR): 0.23, 95% CI: 0.16-0.33, P < 0.0001] and more likely to consider diagnosing female sexual problems as being difficult (aOR: 2.44, 95% CI: 1.73-3.44, P < 0.0001). Compared with the OB/GYNs, the GPs were more likely to report having barriers-for example, \"shortness of the appointment time\" (aOR: 2.36, 95% CI: 1.53-3.63, P < 0.0001), \"personal attitudes and beliefs\" (aOR: 2.07, 95% CI: 1.41-3.67, P = 0.001), and \"lack of knowledge about sexual medicine\" (aOR: 2.05, 95% CI: 1.36-3.10, P = 0.001).</p><p><strong>Conclusions: </strong>Both GPs and OB/GYNs considered the treatment of sexual problems to be an important health care practice; however, the engagement with patients' sexual problems among GPs was less structured.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"677-684"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971453","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":"Early menopause, hysterectomy, and biological aging: Health and Retirement Study.","authors":"Jung Ki Kim, Eileen M Crimmins","doi":"10.1097/GME.0000000000002555","DOIUrl":"10.1097/GME.0000000000002555","url":null,"abstract":"<p><strong>Objective: </strong>This study examines the association between the timing of menopause and hysterectomy and biological aging, focusing on epigenetic and physiological aging markers.</p><p><strong>Methods: </strong>Data were analyzed from women aged 56 and over in the nationally representative Health and Retirement Study (HRS). Regressions of biological aging measured by accelerated epigenetic aging and biological age based on physiological dysregulation on menopause/hysterectomy history were conducted to examine associations of normal-aged and early menopause with and without hysterectomy with biological aging.</p><p><strong>Results: </strong>Hysterectomy, whether following normal-aged or early menopause, or in younger ages, was significantly associated with markers of accelerated biological aging. Women with early menopause or hysterectomy showed accelerated epigenetic aging. Early menopause was associated with accelerated physiological dysregulation only when combined with hysterectomy, suggesting that surgical menopause may be related to accelerated systemic aging processes. Epigenetic clocks were associated with early cellular and molecular aging changes linked to natural early menopause, while physiological dysregulation was associated with the cumulative systemic impacts related to hysterectomy.</p><p><strong>Conclusions: </strong>This study highlights associations between reproductive history and biological aging. These findings underscore the importance of considering both natural and surgical factors in menopause in evaluating aging-related health risks and suggest avenues for targeted interventions to mitigate health risks in women with these reproductive histories.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"692-701"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216304","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":"Psychological function in a randomized trial of continuous nitroglycerin for menopausal hot flashes.","authors":"Emily L Zhao, Carolyn J Gibson, Harini Raghunathan, Michael Schembri, Peter Ganz, Alison J Huang","doi":"10.1097/GME.0000000000002556","DOIUrl":"10.1097/GME.0000000000002556","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate prospective changes in psychological function among menopausal women using continuous nitroglycerin for hot flashes and examine repeated associations between psychological symptoms and hot flashes.</p><p><strong>Methods: </strong>Menopausal women with ≥7 hot flashes/day were randomized to continuous transdermal nitroglycerin (0.2-0.4 mg/h) or placebo for 12 weeks. Psychological function was evaluated using the Center for Epidemiologic Studies-Depression Scale (CES-D), Generalized Anxiety Disorders-7 (GAD-7), and Menopause-Specific Quality of Life (MENQOL) Psychosocial Subscale. Linear mixed models examined treatment effects on mood symptoms from baseline to 5 and 12 weeks. Based on validated 7-day hot flash diaries, additional models examined associations between mood symptoms and hot flash frequency in both groups combined.</p><p><strong>Results: </strong>Among the 141 randomized participants (mean 10.8±3.5 hot flashes/day), nitroglycerin therapy did not improve CES-D or GAD-7 scores (prespecified secondary outcomes) from baseline to 5 and 12 weeks compared with placebo. Greater hot flash frequency was associated with worse GAD-7 scores across all timepoints (β=0.05 per 1 hot flash, P =0.005), but no associations between hot flashes and CES-D or MENQOL Psychosocial scores were observed. Improvement in hot flash frequency was associated with improvement in MENQOL Psychosocial score (β=0.04 per 1 hot flash, P =0.03), but no associations between improvements in hot flashes and improvements in GAD-7 or CES-D scores were detected.</p><p><strong>Conclusions: </strong>In a randomized trial of continuous nitroglycerin, improvements in hot flash frequency did not consistently translate into improvements in mood. Clinicians caring for women with overlapping hot flashes and mood symptoms should consider other factors influencing midlife psychological function.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"702-709"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12313417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011510","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":"Comparison of estrogens and selective estrogen receptor modulators (SERMs) used for menopausal hormone therapy.","authors":"Frank Z Stanczyk, Jane L Yang, Herjan J T Coelingh Bennink, Intira Sriprasert, Sharon Winer, Jean-Michel Foidart, David F Archer","doi":"10.1097/GME.0000000000002547","DOIUrl":"https://doi.org/10.1097/GME.0000000000002547","url":null,"abstract":"<p><p>A variety of natural and synthetic steroidal estrogens, as well as selective estrogen receptor modulators (SERMs), are used for menopausal hormone therapy (MHT) by oral and/or parenteral routes of administration. Two of the most widely used estrogens for MHT are conjugated equine estrogens (CEE) and estradiol (E2); other estrogens include esterified estrogens, piperazine estrone sulfate, estriol, estetrol (E4), E2 valerate, and ethinyl estradiol. Commonly used SERMs include tamoxifen, raloxifene, ospemifene, lasofoxifene, and bazedoxifene. These agents vary widely in their affinities for the estrogen receptors and in their pharmacokinetics, leading to differences in clinical utility. The estrogens are highly effective in treating vasomotor symptoms (VMS) and genitourinary syndrome of menopause (GSM), and they have a beneficial effect on bone density. While some SERMs are approved for osteoporosis prevention and treatment, they have variable effects on VMS and GSM. Studies show that CEE reduces breast cancer risk, but the risk is increased when CEE or E2 are combined with a synthetic progestogen. Tamoxifen and raloxifene are used as breast cancer chemopreventive agents. Although studies suggest a cardioprotective effect of estrogen when administered in early menopause, they are currently not used for this indication. Some estrogens and SERMs may increase the risk of venous thromboembolism by increasing procoagulant factors and decreasing anticoagulant factors. Lastly, E4 has emerged as a novel estrogen with beneficial effects on VMS, GSM, and bone, and neutral effects on the breast and hemostatic factors. A personalized approach, based on each woman's biological profile, is recommended to guide the choice of MHT.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":"32 8","pages":"730-757"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760503","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":"Worsening vasomotor symptoms in the setting of estradiol and semaglutide: a case report.","authors":"Anna E Parker","doi":"10.1097/GME.0000000000002621","DOIUrl":"https://doi.org/10.1097/GME.0000000000002621","url":null,"abstract":"<p><strong>Objective: </strong>To encourage continued research of the delayed gastric emptying effect of glucagon-like peptide-1 receptor agonists and its effect on absorption of orally administered estrogen.</p><p><strong>Methods: </strong>A case is reported of a 51-year-old postmenopausal female prescribed oral estrogen for the treatment of vasomotor symptoms of menopause. The patient reported mood changes and worsening of vasomotor symptoms during semaglutide dose titration. A search for current literature was conducted to investigate any possible connection between semaglutide and the patient's increased symptoms of menopause.</p><p><strong>Results: </strong>During the semaglutide dose titration, the patient experienced changes in mood as well as increased incidence and intensity of vasomotor symptoms. After review of current available literature, a hypothesis was made that glucagon-like peptide-1 receptor agonists may temporarily decrease absorption of oral estrogen. The patient's semaglutide dose titration was slowed with subsequent resolution of mood changes and vasomotor symptoms. The patient's symptom resolution aligns with available literature suggesting that the absorption of some medications is impaired when a glucagon-like peptide-1 receptor agonist is first initiated or dose-increased due to delayed gastric emptying, which subsequently resolves after prolonged stimulation of glucagon-like peptide-1 receptors.</p><p><strong>Conclusions: </strong>Continued research should be considered to identify if there is an effect of the absorption of oral estrogen after the initial dose and/or after a dose titration of semaglutide.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742599","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":"Challenges in developing accurate assays for the measurement of estradiol and testosterone in postmenopausal women.","authors":"Frank Z Stanczyk, Hubert Vesper","doi":"10.1097/GME.0000000000002613","DOIUrl":"https://doi.org/10.1097/GME.0000000000002613","url":null,"abstract":"<p><p>Circulating concentrations of estradiol (E2) and testosterone (T) have been measured in postmenopausal women for many years, predominantly by immunoassays and mass spectrometry (MS) assays. Although the accuracy of E2 and T assays is very important to provide clinically meaningful results, there are challenges in establishing their accuracy. MS assays demonstrate higher accuracy for steroid hormone measurements, but immunoassays can provide clinically meaningful results, especially at high concentrations. The Centers for Disease Control and Prevention (CDC) has established a program to standardize and improve the measurement of steroid hormones, including E2 and T, using liquid chromatography-tandem MS (LC-MS/MS). In addition, the CDC has partnered to establish postmenopausal reference ranges for T and is developing reference intervals for E2. Minimizing some of the technical limitations of the current immunoassays and MS assays should provide better and more accurate assays for patient care.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of migraine and vasomotor symptom severity and duration among naturally menopausal women in Nurses' Health Study II.","authors":"Holly M Crowe, Janet W Rich-Edwards, Kathryn M Rexrode, Hadine Joffe","doi":"10.1097/GME.0000000000002615","DOIUrl":"https://doi.org/10.1097/GME.0000000000002615","url":null,"abstract":"<p><strong>Objective: </strong>Migraine and vasomotor symptoms (VMS) are prevalent brain conditions linked to female sex hormones and negatively impact the quality of life for middle-aged women. We aimed to quantify the association between migraine phenotype and VMS severity and duration across the final menstrual period.</p><p><strong>Methods: </strong>We analyzed data from 21,468 participants in Nurses' Health Study II, an ongoing prospective cohort study of female registered nurses aged 25-42 at baseline in 1989. We included naturally menopausal individuals who reported a final menstrual period from 2007 through 2015. We analyzed the cross-sectional association between self-reported migraine headaches (with and without self-reported clinician diagnosis) and migraine phenotype (with and without aura) and VMS in midlife using logistic regression, adjusting for demographic, lifestyle, and reproductive health factors.</p><p><strong>Results: </strong>Overall, 64% of the cohort reported VMS in the past 4 weeks. Of those experiencing VMS, 7% reported severe VMS and 31% reported VMS lasting ≥5 years. Individuals with recent (past 2 y) migraine in midlife (29%) had 30% (21%-40%) greater odds of reporting VMS than those without migraine (68% of women vs 63%). Among women reporting VMS, recent midlife migraine (vs no recent migraine) was also associated with severe (8% vs 6%, OR = 1.53, 95% CI = 1.30-1.81) and prolonged (35% vs 30% ≥5 years; OR = 1.24, 95% CI = 1.12-1.36) VMS. Although migraine phenotype was unassociated with VMS frequency or duration, migraine with aura and self-reported clinician-diagnosed migraine were more strongly associated with severe VMS than were migraine without aura or self-reported migraine.</p><p><strong>Conclusion: </strong>While the nature of the association remains unclear, our findings highlight the importance of risk assessment and screening for VMS among women with migraine.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690739","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":"Long-term effects of 4 years of menopausal hormone therapy on white matter integrity.","authors":"Laura L Faubion, Elijah Mak, Firat Kara, Nirobul Tosakulwong, Timothy G Lesnick, Angela J Fought, Robert I Reid, Christopher G Schwarz, June Kendall-Thomas, Ekta Kapoor, Julie A Fields, Kent R Bailey, Taryn T James, Rogerio A Lobo, JoAnn E Manson, Lubna Pal, Dustin B Hammers, Eliot A Brinton, Michael Malek-Ahmadi, Marcelle Cedars, Frederick Nicholas Naftolin, Nanette Santoro, Virginia M Miller, Sherman M Harman, N Maritza Dowling, Carey E Gleason, Kejal Kantarci","doi":"10.1097/GME.0000000000002562","DOIUrl":"10.1097/GME.0000000000002562","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the long-term effects of 4 years of menopausal hormone therapy (mHT) on the brain's white matter architecture in women who initiated mHT within 3 years of menopause onset.</p><p><strong>Methods: </strong>The Kronos Early Estrogen Prevention Study (KEEPS) was a multicenter, double-blind, randomized, placebo-controlled 4-year mHT trial with treatment arms of oral conjugated equine estrogens (oCEE), transdermal 17β-estradiol (tE2), and placebo in recently postmenopausal women. KEEPS Continuation was an observational follow-up of KEEPS participants. White matter integrity was evaluated in KEEPS Continuation participants 10 years after KEEPS completion using white matter hyperintensity volume, diffusion magnetic resonance imaging (dMRI) techniques, and cerebral infarcts. Linear regression models were fitted for each brain region to evaluate if there were differences in white matter between KEEPS treatment arms.</p><p><strong>Results: </strong>There was no evidence to suggest the long-term effects of 4 years of mHT on brain white matter in KEEPS Continuation participants [n=266, mean age 67 (58-73)]. No differences in dMRI metrics were found in each of the treatment arms (oCEE n=70; tE2 n=79) when compared to placebo (n=94), following a false discovery rate adjustment for multiple comparisons. There were no statistically significant differences in white matter hyperintensity volume or infarct occurrence when comparing each of the treatment arms to placebo.</p><p><strong>Conclusions: </strong>We found no evidence of the long-term effect of 4-year mHT on white matter integrity when compared to placebo, consistent with emerging evidence of the safety of short-term use of mHT in recently postmenopausal women.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690741","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}