Neurosurgical Review最新文献

{"title":"A systematic review evaluating the effectiveness of nuclear medicine techniques in enhancing the diagnostic accuracy of stereotactic brain biopsies.","authors":"Athanasios Gkampenis, Eleni Romeo, Ioannis Koukoulithras, Marios Lampros, Spyridon Voulgaris, Andreas G Tzakos, George A Alexiou","doi":"10.1007/s10143-025-03698-5","DOIUrl":"https://doi.org/10.1007/s10143-025-03698-5","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the present systematic review is to assess the effectiveness of nuclear medicine methods to improve the diagnostic accuracy of stereotactic brain biopsies (SBB).</p><p><strong>Methods: </strong>A search in Medline, Cochrane, and Scopus databases until 22^nd August 2024 was performed to retrieve relevant studies, aided by a manual search in Google Scholar. After applying predetermined inclusion and exclusion criteria, a data extraction was performed. The risk of bias and concerns regarding applicability were evaluated using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool.</p><p><strong>Results: </strong>Thirteen studies (9 prospective and 4 retrospective) with a total of 337 patients were included in this systematic review. There was a high risk of bias at least in one domain in all studies, while in 4 studies there were high concerns regarding applicability at least in one domain. Positron emission tomography (PET) was used in 12 studies and single photon emission computed tomography (SPECT) in 1 study to design the trajectories of the biopsies. A diagnosis was established through SBB in 282 out of 291 patients, while for the remaining 46 patients there was no relevant data in the studies. Two studies provided data on sensitivity (76 - 81.2 %), specificity (50 - 80 %), and Area Under the Curve (AUC) (56.2 - 89 %).</p><p><strong>Conclusion: </strong>Nuclear medicine has the potential to increase the diagnostic accuracy of SBB by improving targeting precision. Among the radiotracers, ¹¹C-methionine emerged as the most effective, providing superior visualization of the metabolic active region of a brain tumor.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"538"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541548","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":"Multiple synchronous intracranial dural arteriovenous fistulas.","authors":"Xin Su, Zihao Song, Yongjie Ma, Hongqi Zhang, Peng Zhang","doi":"10.1007/s10143-025-03696-7","DOIUrl":"https://doi.org/10.1007/s10143-025-03696-7","url":null,"abstract":"<p><strong>Background: </strong>Intracranial multiple dural arteriovenous fistulas (DAVFs) are rare, with most reports limited to small case series and basic descriptive analyses. To better understand this condition-often linked to lower cure rates and higher progression risk-we conducted a comparative analysis of their angiographic characteristics, clinical presentations, and outcomes.</p><p><strong>Methods: </strong>Data were retrospectively collected from the Dural Arteriovenous Fistula Research and Management in China (DREAM-INI) database. Lesions were classified as multifocal or diffuse based on angiographic features, and as progressive or non-progressive based on follow-up angiographic findings. We compared these subtypes as well as multiple versus single DAVFs, and further investigated the predictors of disease progression in patients with multiple DAVFs.</p><p><strong>Results: </strong>A total of 90 cases of multiple synchronous DAVFs were included. Compared to the multifocal type, diffuse-type patients were younger (P = 0.002), and more frequently exhibited sinus occlusion/stenosis (P = 0.019), sinus-type DAVF (P < 0.001), pial artery supply (P = 0.009), venous congestion (P = 0.030), and lower complete obliteration rates (P = 0.001). Progressive DAVFs were associated with younger age (P = 0.001), sinus-type DAVF (P = 0.020), higher rates of diffuse-type lesions (P < 0.001), pial artery supply (P = 0.037), deep venous drainage (P = 0.032), and venous congestion (P = 0.005). Among the 14 treatment-related complications, 8 (57.1%) were associated with pial artery embolization. Compared to single DAVFs, patients with multiple DAVFs had a significantly lower rate of good outcomes (P < 0.001) and a higher incidence of fistula-related death (P = 0.001). On multivariate analysis, only younger age remained a significant predictor of progression (OR 2.86; 95% CI 1.02-7.99; P = 0.045).</p><p><strong>Conclusions: </strong>Diffuse and progressive types often occur in younger patients and are associated with sinus-type fistulas and venous hypertension-related angioarchitectural features. Disease progression may involve enhanced neoangiogenesis. Treatment of refractory DAVFs should prioritize reducing venous hypertension and improving cerebral hemodynamics, rather than solely pursuing complete obliteration.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"535"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541553","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":"Magnesium sulfate in combination with nimodipine in non-traumatic subarachnoid hemorrhage: a retrospective analysis of short- and long-term mortality.","authors":"Hui Shen, Yibo Yang, Qing Mei, Zhenkun Xiao, Bing Wang, Aihua Liu","doi":"10.1007/s10143-025-03695-8","DOIUrl":"https://doi.org/10.1007/s10143-025-03695-8","url":null,"abstract":"<p><strong>Background: </strong>Subarachnoid hemorrhage (SAH) is a severe neurological condition with high rates of disability and mortality. Although nimodipine is widely used in the treatment of SAH, the potential benefits of magnesium as an adjunct therapy remain unclear. The aim of this study was to explore the impact of magnesium sulfate combined with nimodipine on mortality in patients with non-traumatic SAH (NSAH).</p><p><strong>Methods: </strong>This retrospective cohort study was based on the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, including critically ill patients with NSAH. Patients were categorized into a combined group (N + M) and a nimodipine-only group (N) based on their use of magnesium sulfate and nimodipine during their ICU stay. The primary outcome was one-month all-cause mortality, while the secondary outcome was one-year all-cause mortality. Multivariable analysis was used to adjust for confounding factors. Landmark analysis was performed to assess both short-term and long-term effects.</p><p><strong>Results: </strong>A total of 587 patients were included in the study, with 280 in the N + M group. The one-month and one-year all-cause mortality rate were 15% and 20%, respectively, for the N + M group, compared to 7.2% and 9.1% for the N group. The use of magnesium sulfate was associated with higher one-month (HR 1.89 [95% CI 1.09-3.27]) and one-year (HR 2.08 [95% CI 1.29-3.36]) mortality. Landmark analysis showed that the mortality risk between the two groups remained consistent from two months to one year.</p><p><strong>Conclusion: </strong>In critically ill NSAH patients, the combination of magnesium sulfate and nimodipine was associated with increased all-cause mortality compared to nimodipine alone.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"536"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541552","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":"Evolving strategies in the management of vertebral artery dissecting aneurysms involving the posterior inferior cerebellar artery: a systematic review and meta-analysis.","authors":"Mustafa Ismail, Norito Kinjo, Rania H Al-Taie, Alejandro M Spiotta","doi":"10.1007/s10143-025-03694-9","DOIUrl":"10.1007/s10143-025-03694-9","url":null,"abstract":"<p><strong>Background: </strong>Vertebral artery dissecting aneurysms (VADAs) involving the posterior inferior cerebellar artery (PICA) origin present a unique therapeutic challenge due to high rupture risk, complex anatomy, and the critical need to preserve brainstem perfusion. Despite the increasing use of endovascular strategies, no prior meta-analysis has specifically evaluated outcomes for this clinically high-risk subgroup.</p><p><strong>Objective: </strong>To systematically review and quantitatively synthesize available data on the endovascular management of VADAs involving the PICA origin.</p><p><strong>Methods: </strong>A comprehensive literature search of PubMed and Scopus was conducted per PRISMA guidelines. Studies reporting clinical outcomes for VADAs involving the PICA origin treated with endovascular techniques were included. Pooled estimates were calculated for key outcomes using a random-effects meta-analysis model. Heterogeneity and publication bias were assessed.</p><p><strong>Results: </strong>This review included 141 patients. The majority (90.1%) presented with ruptured aneurysms. In the literature, stent-assisted coiling (SAC) was the most frequently employed reconstructive strategy, with a 12.5% recurrence rate (95% CI: 6-24%) and a 20% rebleeding rate (95% CI: 12-38%, p < 0.001) according to one-arm proportional meta-analysis. The overall complete occlusion following endovascular therapy was 49.2% (95% CI: 94-100%). PICA patency was preserved in 43.7% of cases. The overall ischemic complication rate was 15.6%, and mortality was 6.4%, predominantly in patients undergoing deconstructive treatments. Most patients achieved favorable neurological outcomes (mRS ≤ 2).</p><p><strong>Conclusions: </strong>Flow diversion appears to be a promising option for PICA-involving VADAs, demonstrating comparable early occlusion rates with no reported re-bleeding in the limited cases available, and a lower tendency to recur compared with SAC. SAC retains value in anatomically favorable, nondominant lesions, though its higher rebleeding risk limits its use when branch hemodynamics are complex. Larger, prospective multicenter studies are needed to refine flow-diverter protocols and define the specific circumstances in which adjunctive or stent-assisted techniques remain advantageous.</p><p><strong>Clinical trial: </strong>Not applicable.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"534"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144541551","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":"Manipulation of intracranial arteries is associated with consistent vessel diameter reductions during microsurgical aneurysm clipping.","authors":"Ardavan Kashtiara, Vincent Raymaekers, Dieter Thijs, Rabih Aboukais, Antoine Devalckeneer, Philippe Bourgeois, Hieronymus Damianus Boogaarts, Tomas Menovsky","doi":"10.1007/s10143-025-03573-3","DOIUrl":"https://doi.org/10.1007/s10143-025-03573-3","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"532"},"PeriodicalIF":2.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529028","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":"Neutrophil-to-High density lipoprotein cholesterol ratio predicts early hematoma expansion in patients with spontaneous intracerebral hemorrhage.","authors":"Suzhen Lai, Chaoying Wang, Yizhao Lin, Baocai Kang, Jianqun Wang, Han Meng, Chunjuan Cao","doi":"10.1007/s10143-025-03682-z","DOIUrl":"https://doi.org/10.1007/s10143-025-03682-z","url":null,"abstract":"<p><strong>Background: </strong>The neutrophil to high-density lipoprotein cholesterol ratio (NHR) is a novel inflammatory-metabolic biomarker that reflects the dynamic interplay between systemic inflammation and lipid-mediated vascular protection. While elevated NHR has been linked to the incidence and prognosis of acute ischemic stroke, its association with early hematoma expansion (HE) in spontaneous intracerebral hemorrhage (sICH) remains unclear.</p><p><strong>Methods: </strong>Demographic data, clinical characteristics, laboratory values, and functional outcomes of patients diagnosed with sICH were retrospectively collected and analyzed. NHR levels were calculated at admission and categorized into tertiles. Multivariate logistic regression was conducted to identify independent predictors of early HE. Weighted logistic regression, restricted cubic spline (RCS) models, and propensity score matching (PSM) were employed to estimate the association between NHR and early HE.</p><p><strong>Results: </strong>A total of 433 patients were included, of whom 13.86% experienced early HE. The incidence of HE increased significantly across NHR tertiles, reaching 22.60% in the highest NHR tertile versus 5.56% in the lowest tertile (P < 0.001). In the adjusted model, patients with sICH in the highest tertile had a 4.76-fold increased risk of early HE (odds ratio = 4.76; 95% confidence interval 2.04-11.11, P < 0.001) compared to those in the lowest tertile. RCS analysis demonstrated a linear relationship between NHR and early HE (nonlinearity P > 0.05). Subgroup analyses confirmed the robustness of this association persisted across different groups (all P for interactions> 0.05). Upon achieving covariate balance through PSM, the positive association between NHR and early HE was further supported. Additionally, higher NHR levels were consistently associated with poorer functional outcomes at 90 days before and after PSM.</p><p><strong>Conclusion: </strong>Elevated NHR upon admission is independently associated with early HE and unfavorable 90-day outcomes in patients with sICH. As a simple, cost-effective, and readily available biomarker, NHR may offer value in early risk stratification and individualized clinical decision-making in the acute management of sICH.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"533"},"PeriodicalIF":2.5,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529029","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":"Does duration of nimodipine therapy impact outcome in aneurysmal subarachnoid hemorrhage: systematic review and meta-analysis.","authors":"Spencer Oslin, Wilson Hoyt, Sherwin Tavakol, Hakeem Shakir, Andrew Bauer, Shyian Jen, Christopher Graffeo","doi":"10.1007/s10143-025-03672-1","DOIUrl":"10.1007/s10143-025-03672-1","url":null,"abstract":"<p><p>Aneurysmal subarachnoid hemorrhage (aSAH) is a neurosurgical emergency with high morbidity and mortality risks. Vasospasm, a severe subacute complication, may be mitigated by nimodipine, a calcium channel blocker. The optimal duration of nimodipine therapy remains uncertain. We sought to evaluate the optimal duration of nimodipine therapy in relation to overall morbidity in aSAH patients through a systematic review and meta-analysis. A PRISMA-compliant systematic review searched MEDLINE, EMBASE, and Cochrane Library (1/1975-9/2024). Included studies reported nimodipine protocols and standardized outcomes. Data extracted included demographics, nimodipine dosing, duration, and outcomes. The primary outcome was overall morbidity, assessed via extended Glasgow Outcome Scale (eGOS), Glasgow Outcome Scale (GOS), or modified Rankin Scale (mRS). The secondary outcome was neuroimaging-validated delayed cerebral ischemia (DCI) incidence. Random-effects meta-analyses were performed. Fourteen studies (19 cohorts) included 759 standard-of-care (SOC, 21-day nimodipine) and 781 dose duration reduction (DDR, < 21 days) patients. SOC had a pooled favorable outcome proportion of 0.52 [95% CI: 0.34-0.70], versus 0.74 [95% CI: 0.64-0.83] for DDR (p = 0.03). Subgroup analyses showed significant differences by outcome scale (p < 0.01) and administration route (p = 0.01), with oral DDR linked to better outcomes (p = 0.02). Heterogeneity was significant (I² = 95%, p < 0.01). DCI incidence was 0.39 [95% CI: 0.20-0.57] in SOC and 0.31 [95% CI: 0.18-0.44] in DDR (p = 0.50). DDR nimodipine protocols do not increase aSAH morbidity or DCI incidence compared to SOC and may improve outcomes. These findings support individualized treatment durations, especially for patients with adverse effects, though heterogeneity necessitates cautious interpretation.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"531"},"PeriodicalIF":2.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512200","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":"Tubular retractors in neuro-oncological surgery: a systematic review and meta-analysis.","authors":"Amir Rafati Fard, Owen Hibberd, Isaac Akinduro, Zainab Bhatti, Kieran J Smith, Reece Patel, Sejal Karmarkar, Oliver D Mowforth, Ciaran S Hill","doi":"10.1007/s10143-025-03677-w","DOIUrl":"10.1007/s10143-025-03677-w","url":null,"abstract":"<p><p>Neuro-oncological surgery necessitates a careful balance between maximising tumour resection whilst minimising damage to healthy brain parenchyma. Tubular retractors represent an emerging tool proposed to facilitate in the optimisation of this onco-functional balance. The objective was to evaluate the evidence regarding tubular retractors in neuro-oncological surgery. A systematic review and meta-analysis was performed. Studies reporting on surgical outcomes of tubular retractors in adult neuro-oncological cases were eligible. Medline, Embase, Cochrane Library, ClinicalTrials.gov, and ICTRP were searched to 14th July 2024. Duplicate title/abstract screening, data extraction, and risk of bias assessments were conducted. Prevalence of gross total resection (GTR) and complications were calculated using random effects models. 49 studies were included in the final analysis with a total of 684 patients. Combined pooled prevalence for GTR was 76% (95% CI: 67-85%), whilst for complications was 14% (95% CI: 8-20%). GTR rate by tumour histology was: 52% for gliomas (95% CI: 41-62%), 80% for metastases (95% CI: 65-92%), and 100% for colloid cysts (95% CI: 99-100%). Complication rate by tumour histology was: 16% for gliomas (95% CI: 5-30%), 12% for metastases (95% CI: 1-28%), and 16% for colloid cysts (95% CI: 8-24%). There was no significant difference between tubular retractor brands and GTR or complication rate (p > 0.05). Despite the mounting interest regarding the utility of tubular retractors in neuro-oncological surgery, the current evidence remains largely in the form of case series. Prospective studies with greater sample sizes, longer follow-up, and direct comparison to conventional retraction are now needed.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"530"},"PeriodicalIF":2.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144507102","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":"Using a syringe as tubular retractor and working channel in minimally invasive cranial and spinal neurosurgery.","authors":"Guenther C Feigl, Daniel Staribacher, Iván N Camal Ruggieri, Gavin Britz, Dzmitry Kuzmin","doi":"10.1007/s10143-025-03642-7","DOIUrl":"10.1007/s10143-025-03642-7","url":null,"abstract":"<p><p>Minimally invasive spinal and cranial neurosurgery often requires tissue retraction. However, excessive tissue retraction is contrary to the principles of minimally invasive neurosurgery. Therefore, any retractor used should be small and atraumatic. Circular plastic retractors made from syringes of various sizes meet these requirements. We report a case series of patients with various cranial and spinal pathologies who underwent surgeries using \"self-made\" retractors made from plastic syringes of various sizes (2 mL, 5 mL, and 10 mL). All surgeries were performed via minimally invasive approaches. In all cases, the goals of surgical treatment were achieved with no neurological deficits. The use of \"self-made\" plastic retractors can be helpful in spinal and cranial minimally invasive neurosurgery. Making retractors from plastic syringes and using them is not labor-intensive. This method can extend the possibilities of the neurosurgeon, especially in the field of minimally invasive neurosurgery. Clinical trial number: Not applicable.</p>","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"529"},"PeriodicalIF":2.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144485267","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":"Risk factors for rupture of intracranial aneurysms in patients with autoimmune diseases.","authors":"Shenkun Tang, Yongkai Qin, Liyang Zhang, Yingchao Jing, Aihua Liu, Baorui Zhang","doi":"10.1007/s10143-025-03621-y","DOIUrl":"https://doi.org/10.1007/s10143-025-03621-y","url":null,"abstract":"","PeriodicalId":19184,"journal":{"name":"Neurosurgical Review","volume":"48 1","pages":"526"},"PeriodicalIF":2.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476130","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}