Neurocritical Care最新文献

{"title":"Role of Music Therapy in Neurocritical Care for Patients with Acute Brain Injury with Disorders of Consciousness: A Narrative Review and Proposed Framework for Practice.","authors":"Kerry Devlin, Junaid Ansari, Rohan Mathur, Vishank Shah, Alexander Pantelyat, Jose I Suarez","doi":"10.1007/s12028-025-02332-y","DOIUrl":"https://doi.org/10.1007/s12028-025-02332-y","url":null,"abstract":"<p><p>Music therapy (MT) holds promise as a treatment for patients with severe acute brain injury (SABI) with disorders of consciousness (DoC) admitted to critical care units. MT leverages the intrinsic properties of music to engage patients and their families, promoting recovery through neurological, psychological, and physiological mechanisms. Although MT is routinely practiced in intensive care and rehabilitation settings, its applications in a neurocritical care context during acute DoC treatment and recovery are underexplored. Further, the subjective nature of music, music preferences, and the variability in patient responses to music-particularly in patients with SABI and DoC-pose unique challenges for implementing a one-size-fits-all approach. Through our institution's experience with MT and a review of previously published evidence, this article illustrates the application of our MT approach as a noninvasive, holistic, and individualized intervention. A case vignette explores MT in the clinical care of a patient with SABI admitted to the neurocritical care unit across a 9-week period, demonstrating the potential of MT to enhance quality of care and recovery outcomes over time. A family impact statement and emerging practice framework are also included to further elucidate the ways in which MT may enhance quality of care and patient recovery in neurocritical care settings.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794958","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":"Effect of APOE ε4 Gene on Perihematomal Edema in Intracerebral Hemorrhage: A Prospective Study.","authors":"Long Wang, Guofeng Wu, Ai Cao, Lei Huang, Haoqi Wang, Siying Ren, Bo Gao, Likun Wang","doi":"10.1007/s12028-025-02330-0","DOIUrl":"https://doi.org/10.1007/s12028-025-02330-0","url":null,"abstract":"<p><strong>Background: </strong>Intracerebral hemorrhage (ICH) leads to perihematomal edema (PHE), exacerbating brain swelling and functional deterioration. Blood-brain barrier disruption has been observed in carriers of the apolipoprotein E (APOE) ε4 genotype. The study focused on the impact of APOE ε4 in PHE and its underlying molecular mechanisms.</p><p><strong>Methods: </strong>This study was a single-center, prospective, and nested cohort study involving patients with ICH admitted to the emergency department of the Affiliated Hospital of Guizhou Medical University between April 2023 and October 2024. We included patients who underwent surgery within 24 h of onset. APOE ε4 and APOE ε3 groups were formed based on hemorrhage location, age, and hemorrhage volume using a 1:1 stratified matching method. We analyzed the initial cranial computed tomography scans taken within 24 h after onset; we measured hematoma volume and edema volume (EV) and calculated the combined edema and hematoma volume, the preoperative edema coefficient (PEC), and the edema expansion distance (EED). In addition, cerebrospinal fluid samples from the hematoma cavity were collected during surgery, and enzyme-linked immunosorbent assays were used to measure the expression levels of APOE, low-density lipoprotein receptor-related protein 1 (LRP1), cyclophilin A (CypA), nuclear factor κB (NF-κB), matrix metalloproteinase 9 (MMP-9), occludin, and ZO-1.</p><p><strong>Results: </strong>Among 48 patients (24 per group), APOE ε4 carriers exhibited greater PHE than APOE ε3 carriers, reflected by increased EV, PEC, and EED. After adjusting for hematoma volume, linear regression showed APOE ε4, MMP-9, and occludin were positively associated with PEC, whereas LRP1 had an inverse relationship (β =  - 0.2, p = 0.008). Mediation analysis revealed APOE ε4 influenced PEC indirectly via MMP-9 (effect size = 0.38, p < 0.001), accounting for 32.84% of the total effect.</p><p><strong>Conclusions: </strong>The APOE ε4 genotype in patients with ICH may encode an APOE isoform with a lower affinity for LRP1, which decreases the inhibitory effect of LRP1 on MMP-9 activity, leading to blood-brain barrier disruption and the exacerbation of PHE, as indicated by increased EV, PEC, and EED.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789618","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 Between Hematoma Edema Complex and Outcomes of Primary Intracerebral Hemorrhage.","authors":"Jayantee Kalita, Dhiraj Kumar, Sandeep K Gupta, Prakash C Pandey, Roopali Mahajan, Vivek Singh","doi":"10.1007/s12028-025-02321-1","DOIUrl":"https://doi.org/10.1007/s12028-025-02321-1","url":null,"abstract":"<p><strong>Background: </strong>Intracerebral hematoma (ICH) expansion occurs within 24 h, but perihematoma edema (PHE) may increase later due to blood breakdown products, leading to clinical deterioration and poor outcomes. There is a paucity of prospective studies evaluating the role of hematoma edema complex (HEC) and PHE in the death and disability of patients with ICH. We report the association between day 1 and day 7 HEC and PHE and outcomes at 3 months in patients with ICH.</p><p><strong>Methods: </strong>Patients with primary ICH admitted within 24 h of ictus were included. Their demographic details, stroke risk factors, and Glasgow Coma Scale and National Institutes of Health Stroke Scale scores were recorded. A cranial computerized tomographic (CT) scan was done at admission and on the 7th day or earlier if there was clinical deterioration. Volumes of ICH, HEC, PHE, relative PHE, and midline shift were measured. Outcomes at 3 months were measured using the modified Rankin Scale.</p><p><strong>Results: </strong>Ninety patients with a median age of 57 (range 38-80) years were included. The majority had ganglionic or thalamic ICH (70 patients, 77.8%), and 20 patients (22.2%) had lobar ICH. HEC, PHE, and midline shift significantly increased on the repeat CT scan. Baseline ICH volume correlated with expansion in HEC (r = 0.97, P < 0.0001) and PHE (r = 0.54, P < 0.001). There was an independent association between HEC on the repeat CT scan and death (adjusted odds ratio 1.05, 95% confidence interval 1.02-1.08, P < 0.001) and poor outcome (adjusted odds ratio 0.87; 95% confidence interval 0.78-0.98, P = 0.02).</p><p><strong>Conclusions: </strong>There was an independent association between HEC and outcomes in patients with primary ICH.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789617","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":"Sedation Practices in Mechanically Ventilated Neurocritical Care Patients from 19 Countries: An International Cohort Study.","authors":"Shi Nan Feng, Lindsay H Laws, Camilo Diaz-Cruz, Raphael Cinotti, Marcus J Schultz, Karim Asehnoune, Robert D Stevens, Chiara Robba, Sung-Min Cho","doi":"10.1007/s12028-024-02200-1","DOIUrl":"10.1007/s12028-024-02200-1","url":null,"abstract":"<p><strong>Background: </strong>Our objective was to characterize the impact of common initial sedation practices on invasive mechanical ventilation (IMV) duration and in-hospital outcomes in patients with acute brain injury (ABI) and to elucidate variations in practices between high-income and middle-income countries.</p><p><strong>Methods: </strong>This was a post hoc analysis of a prospective observational data registry of neurocritically ill patients requiring IMV. The setting included 73 intensive care units (ICUs) in 18 countries, with a total of 1,450 patients with ABI requiring IMV. There were no interventions.</p><p><strong>Results: </strong>Patients were categorized into day 1 propofol, midazolam, propofol and midazolam, dexmedetomidine, or sodium thiopental. The primary outcome was duration of IMV. Secondary outcomes were ICU and hospital mortality, ICU length of stay, days to first extubation, extubation failure, and withdrawal of life-sustaining therapy. Multivariable analyses were adjusted for clinically preselected covariates. Of 1,450 included patients (median age 54 years, 66% male), 41.2% (n = 597) were started on propofol, 26.1% (n = 379) were started on midazolam, 19.9% were started on propofol and midazolam, 0.3% (n = 5) were started on sodium thiopental, 0.7% (n = 10) were started on dexmedetomidine, and 11.8% (n = 171) were treated without sedation. After adjustment, there was no significant difference in IMV duration between patients who received midazolam (aβ = 0.64, p = 0.43, 95% confidence interval [CI] - 0.96 to 2.24) or propofol and midazolam (aβ = 0.32, p = 0.46, 95% CI - 1.44 to 2.12) compared with patients who received propofol. Patients who were started on midazolam had an average length of ICU stay that was 2.78 days longer than patients started on propofol (p = 0.003, 95% CI 0.94-4.63). There were no differences in mortality, days to first extubation, extubation failure, or withdrawal of life-sustaining therapy. Patients from high-income countries (n = 1,125) were more likely to receive propofol on day 1 (45.7 vs. 25.5%), whereas patients from middle-income countries (n = 325) were more likely to receive midazolam (32.6 vs. 24.3%) (p < 0.001).</p><p><strong>Conclusions: </strong>In an international registry of patients with ABI requiring IMV, IMV duration did not differ significantly relative to initial sedation strategy. However, patients started on midazolam had longer ICU stay.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"232-242"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952393","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":"Continuous Electroencephalography in Acute Liver Failure: Findings and Prognostic Value.","authors":"Denise F Chen, Mirza Farrque, Ioannis Karakis, Navnika Gupta, Andres Rodriguez Ruiz, Prem Kandiah","doi":"10.1007/s12028-025-02216-1","DOIUrl":"10.1007/s12028-025-02216-1","url":null,"abstract":"<p><strong>Background: </strong>Neurologic complications contribute significantly to morbidity and mortality in acute liver failure (ALF). However, clinical assessment of neurologic function in this population is often challenging. Continuous electroencephalography (cEEG) is a low-risk, noninvasive diagnostic tool that can monitor real-time cerebral function. We aimed to investigate cEEG findings and prognostic significance of specific EEG features in a cohort of strictly defined patients with ALF.</p><p><strong>Methods: </strong>This was a retrospective, single-center study of adult patients with ALF who underwent cEEG monitoring for at least 6 h between 2013 and 2022. Clinical, laboratory, imaging, and treatment characteristics were evaluated. cEEG variables included background continuity, background frequency, the presence of sporadic epileptiform discharges, rhythmic or periodic patterns, and electrographic or electroclinical seizures. The primary outcome was mortality or transition to end-of-life care during the index admission.</p><p><strong>Results: </strong>A total of 32 patients with ALF were included. 56.3% of patients had rhythmic or periodic patterns, of which the majority were generalized periodic discharges (37.5%). 12.5% of patients had sporadic epileptiform discharges, and 6.3% of patients demonstrated electrographic or clinical seizures. Eighteen (56.3%) patients died or were transitioned to end-of-life care during the index admission. Worsening background continuity or frequency over the course of the cEEG recording was significantly associated with poor outcome (p = 0.001, p = 0.007, respectively), with a 100% mortality rate in patients demonstrating these EEG trends. A worst recorded continuity of suppression, attenuation, and burst-suppression was also associated with poor outcome (p = 0.012). The presence of rhythmic or periodic patterns, sporadic epileptiform discharges, or seizures was not predictive of outcome.</p><p><strong>Conclusions: </strong>Worsening cEEG background continuity or frequency is associated with poor outcome in adults with ALF. cEEG may contribute useful prognostic information in these patients, in conjunction with other laboratory and clinical markers of disease severity.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"91-100"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370794","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":"Correction: Evolution of EEG Findings in Patients with Acute Brain Injury.","authors":"Jackson A Narrett, MarieElena Byrnes, Emily J Gilmore, Lawrence J Hirsch, Vineet Punia, Adithya Sivaraju","doi":"10.1007/s12028-025-02266-5","DOIUrl":"10.1007/s12028-025-02266-5","url":null,"abstract":"","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"361"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029601","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":"Authors Response: Safety Analysis of Visual Percutaneous Tracheostomy in Neurocritical Care Patients with Anticoagulation and Antithrombosis.","authors":"Kun Yang, Xiaopeng Guo, Qinfeng Han","doi":"10.1007/s12028-025-02256-7","DOIUrl":"10.1007/s12028-025-02256-7","url":null,"abstract":"","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"359-360"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014036","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 Dipeptidyl Peptidase-4 Inhibitor Saxagliptin as a Candidate Treatment for Disorders of Consciousness: A Deep Learning and Retrospective Clinical Analysis.","authors":"Daniel Toker, Jeffrey N Chiang, Paul M Vespa, Caroline Schnakers, Martin M Monti","doi":"10.1007/s12028-025-02217-0","DOIUrl":"10.1007/s12028-025-02217-0","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements in the neuroscience of consciousness, no new medications for disorders of consciousness (DOC) have been discovered in more than a decade. Repurposing existing US Food and Drug Administration (FDA)-approved drugs for DOC is crucial for improving clinical management and patient outcomes.</p><p><strong>Methods: </strong>To identify potential new treatments among existing FDA-approved drugs, we used a deep learning-based drug screening model to predict the efficacy of drugs as awakening agents based on their three-dimensional molecular structure. A retrospective cohort study from March 2012 to October 2024 tested the model's predictions, focusing on changes in Glasgow Coma Scale (GCS) scores in 4047 patients in a coma from traumatic, vascular, or anoxic brain injury.</p><p><strong>Results: </strong>Our deep learning drug screens identified saxagliptin, a dipeptidyl peptidase-4 inhibitor, as a promising awakening drug for both acute and prolonged DOC. The retrospective clinical analysis showed that saxagliptin was associated with the highest recovery rate from acute coma among diabetes medications. After matching patients by age, sex, initial GCS score, coma etiology, and glycemic status, brain-injured patients with diabetes on incretin-based therapies, including dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 analogues, recovered from coma at significantly higher rates compared to both brain-injured patients with diabetes on non-incretin-based diabetes medications (95% confidence interval of 1.8-14.1% higher recovery rate, P = 0.0331) and brain-injured patients without diabetes (95% confidence interval of 2-21% higher recovery rate, P = 0.0272). Post matching, brain-injured patients with diabetes on incretin-based therapies also recovered at a significantly higher rate than patients treated with amantadine (95% confidence interval for the difference 2.4-25.1.0%, P = 0.0364). A review of preclinical studies identified several pathways through which saxagliptin and other incretin-based medications may aid awakening from both acute and chronic DOC: restoring monoaminergic and GABAergic neurotransmission, reducing brain inflammation and oxidative damage, clearing hyperphosphorylated tau and amyloid-β, normalizing thalamocortical glucose metabolism, increasing neural plasticity, and mitigating excitotoxic brain damage.</p><p><strong>Conclusions: </strong>Our findings suggest incretin-based medications in general, and saxagliptin in particular, as potential novel therapeutic agents for DOC. Further prospective clinical trials are needed to confirm their efficacy and safety in DOC.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"101-118"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189401","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 Evolution of Neurocritical Care Pharmacy: Historical Perspectives and Future Horizons.","authors":"Denise H Rhoney, Aaron M Cook, Karen Berger, Sherif Hanafy Mahmoud, Gretchen M Brophy, Salia Farrokh, Theresa Human, John Lewin, Jeffrey J Mucksavage, Kiranpal S Sangha, Eljim P Tesoro","doi":"10.1007/s12028-025-02239-8","DOIUrl":"10.1007/s12028-025-02239-8","url":null,"abstract":"<p><p>This article reviews the history and evolution of the neurocritical care (NCC) pharmacy, a subspecialty of critical care pharmacy that focuses on the care of patients with acute neurological disorders. The origins of NCC pharmacies in the 1960s and 1970s are described, when pharmacists began to participate in patient rounds, clinical pharmacokinetic consults, and translational research with neurosurgeons and neurologists. The article also discusses the current state of NCC pharmacy practice, research, and education, highlighting the role of pharmacists as essential members of the NCC team, the contributions of pharmacists to NCC research and guidelines, and the challenges and opportunities for education and training in this unique subspecialty. Finally, the article envisions the future of NCC pharmacy, emphasizing the need for high expectations, visionary leadership, innovative education models, a robust scientific foundation, and multidisciplinary collaboration to advance NCC pharmacy and improve patient outcomes.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"318-332"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710723","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":"Development and External Validation of a Prediction Model for Early Postoperative Cerebral Infarction on Computed Tomography in Spontaneous Intracerebral Hemorrhage.","authors":"Kun Lin, Zhi-Yun Zhan, Yong-Xiu Tong, Zhi-Cheng Lin, Yin-Hai Tang, Yuan-Xiang Lin","doi":"10.1007/s12028-024-02193-x","DOIUrl":"10.1007/s12028-024-02193-x","url":null,"abstract":"<p><strong>Background: </strong>Early postoperative cerebral infarction (ePCI) significantly worsens outcomes in patients with spontaneous intracerebral hemorrhage (ICH) undergoing surgery. This study aimed to develop and externally validate a nomogram to assess ePCI risk.</p><p><strong>Methods: </strong>Adult patients with spontaneous supratentorial ICH who underwent surgery between May 2015 and September 2022 at a large tertiary referral center (development cohort) and another tertiary referral center (external validation cohort) were retrospectively included. ePCI was defined as a newly identified permanent low-density lesion observed within 72 h of surgery on computed tomography. We developed a nomogram using predictors identified through least absolute shrinkage and selection operator analysis. The model's discrimination, calibration, and clinical utility were evaluated.</p><p><strong>Results: </strong>The development cohort (n = 453) had 51 ePCI cases, and the external validation cohort (n = 184) had 20. The model incorporated the Glasgow Coma Scale (GCS), the Original Intracerebral Hemorrhage Scale (oICH), uncal herniation stage, and hematoma volume, demonstrating strong discrimination with an area under the receiver operating characteristic curve (AUC) of 0.915 (95% confidence interval [CI] 0.882-0.948) in the development cohort and an AUC of 0.942 (95% CI 0.897-0.988) in the external independent cohort. The model also showed excellent calibration and clinical applicability.</p><p><strong>Conclusions: </strong>This nomogram, including the GCS, the oICH, uncal herniation stage, and hematoma volume, effectively predicts ePCI risk in patients with spontaneous supratentorial ICH.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"298-307"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370798","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}