Neurology最新文献

{"title":"Norman J. Schatz, MD (1936-2024).","authors":"Steven L Galetta, Teshamae S Monteith","doi":"10.1212/WNL.0000000000213331","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213331","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 3","pages":"e213331"},"PeriodicalIF":7.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Covert Vascular Brain Injury and Cognitive Dysfunction Among Chinese Adults Living in Canada and China: The CAHHM and PURE-MIND Studies.","authors":"Calvin Ke, Sonia S Anand, Eric E Smith, Karleen M Schulze, Alan Moody, Scott Lear, Paul Poirier, Trevor Dummer, Dipika Desai, Vivekanandan Thayalasuthan, Salim Yusuf, Koon Kang Teo, Andreas Wielgosz, Douglas Lee","doi":"10.1212/WNL.0000000000210246","DOIUrl":"10.1212/WNL.0000000000210246","url":null,"abstract":"<p><strong>Background and objective: </strong>It is unclear whether variation in covert cerebrovascular disease prevalence is attributable to ethnic differences or to other factors. We aimed to examine the associations of country of residence with covert vascular brain injury (VBI) and cognitive dysfunction among Chinese adults residing in Canada and China.</p><p><strong>Methods: </strong>This was a multisite cross-sectional study of Chinese adults aged 40-80 years in the Canadian Alliance for Healthy Hearts and Healthy Minds (CAHHM; January 1, 2014, to December 31, 2018) and Prospective Urban Rural Epidemiological-Mind (PURE-MIND; November 1, 2010, to July 31, 2015) cohorts living in Canada and China. The exposure was country of residence. The co-primary outcomes were covert VBI (defined as MRI findings of high white matter hyperintensities or covert brain infarct) and cognitive dysfunction (defined as a Montreal Cognitive Assessment [MoCA] score <26). We used generalized linear models to describe the association between country of residence and each outcome, adjusting for selected covariates.</p><p><strong>Results: </strong>We included 884 adults living in Canada (mean age 57.3 years, 55.4% female) and 473 living in China (mean age 56.8 years, 60.3% female). Participants in Canada had a lower prevalence of covert VBI (age 65-79 years: male, 11.5%; female, 12.2%) than those living in China (age 65-79 years: male, 62.9%; female, 52.1%). Prevalence of MoCA score <26 was lower among men and women in Canada (age 65-79 years: 40.2% and 30.0%, respectively) than among men and women in China (age 65-79 years: 74.3% and 79.2%). Living in China was associated with a 6-fold increase in the odds of covert VBI (5.85, 4.06-8.45), which remained significant after covariate adjustment. Living in China was associated with a 7-fold increase in the odds of MoCA score <26 (6.98, 5.38-9.04), which was no longer significant after covariate adjustment.</p><p><strong>Discussion: </strong>Despite sharing a similar ethnicity, the prevalence of covert VBI and cognitive dysfunction varied substantially by country of residence. Disparities in cognitive dysfunction were completely explained by differences in education and traditional cerebrovascular risk factors, whereas disparities in covert VBI prevalence were only partially explained by differences in such factors, suggesting a role for other environmental factors.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 3","pages":"e210246"},"PeriodicalIF":7.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Neurology® Open Access</i>: Welcoming a New Member of the <i>Neurology®</i> Family of Journals.","authors":"Amy C Kunchok, Morgan S Sorenson, Patricia K Baskin, José G Merino","doi":"10.1212/WNL.0000000000213350","DOIUrl":"https://doi.org/10.1212/WNL.0000000000213350","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 3","pages":"e213350"},"PeriodicalIF":7.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tenecteplase for the Treatment of Pediatric Arterial Ischemic Stroke: A Safety Surveillance Report.","authors":"Lisa R Sun, Sarah Lee, Jacqueline Lee-Eng, Megan Barry, Maria M Galardi, Dana Harrar, Sahar M Hassanein, Michael J Rivkin, Marcela Torres, Jenny L Wilson, Catherine Amlie-Lefond, Kristin Guilliams","doi":"10.1212/WNL.0000000000210310","DOIUrl":"https://doi.org/10.1212/WNL.0000000000210310","url":null,"abstract":"<p><strong>Objectives: </strong>Intravenous tenecteplase (TNK) is increasingly used to treat adult patients with acute arterial ischemic stroke, but the risk profile of TNK in childhood stroke is unknown. This study aims to prospectively gather safety data regarding TNK administration in children.</p><p><strong>Methods: </strong>Since December 2023, a monthly email survey was sent to participants recruited from the International Pediatric Stroke Study and Pediatric Neurocritical Care Research Group querying recent experience with TNK in childhood stroke. Limited demographic, safety, and outcome data were collected in a secure REDCap database. Detailed clinical data were not collected.</p><p><strong>Results: </strong>Eleven children were reported to have received TNK between February 2023 and January 2024. Ten were adolescents (13-17 years old), and 1 was between 5 and 12 years old. TNK was given at an outside facility before transfer to the reporting facility in 7 cases. Final diagnosis was stroke in 8 cases and stroke mimic in 3 cases. No major safety concerns or TNK-related intracranial hemorrhages on follow-up imaging were reported.</p><p><strong>Discussion: </strong>Our initial data suggest that TNK may be safe in childhood arterial ischemic stroke. Strategically designed prospective studies are needed to further define safety, optimal dosage, and efficacy of TNK in acute pediatric stroke.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 3","pages":"e210310"},"PeriodicalIF":7.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiseizure Medications in Poststroke Seizures: A Systematic Review and Network Meta-Analysis.","authors":"Shubham Misra, Selena Wang, Terence J Quinn, Jesse Dawson, Johan Zelano, Tomotaka Tanaka, James C Grotta, Erum Khan, Nitya Beriwal, Melissa C Funaro, Sravan Perla, Priya Dev, David Larsson, Taimoor Hussain, David S Liebeskind, Clarissa Lin Yasuda, Hamada Hamid Altalib, Hitten P Zaveri, Amr Elshahat, Gazala Hitawala, Ethan Y Wang, Rachel Kitagawa, Abhishek Pathak, Fabien Scalzo, Masafumi Ihara, Katharina S Sunnerhagen, Matthew R Walters, Yize Zhao, Nathalie Jette, Scott E Kasner, Patrick Kwan, Nishant K Mishra","doi":"10.1212/WNL.0000000000210231","DOIUrl":"https://doi.org/10.1212/WNL.0000000000210231","url":null,"abstract":"<p><strong>Background and objectives: </strong>The most effective antiseizure medications (ASMs) for poststroke seizures (PSSs) remain unclear. We aimed to determine outcomes associated with ASMs in people with PSS.</p><p><strong>Methods: </strong>We systematically searched electronic databases for studies on patients with PSS on ASMs. Our outcomes were seizure recurrence, adverse events, drug discontinuation rate, and mortality. We assessed the risk of bias using Cochrane Risk of Bias tool for randomized controlled trials and Risk Of Bias In Non-randomized Studies of Interventions tools. Using levetiracetam as the reference treatment, we conducted a frequentist network meta-analysis and determined the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation methodology.</p><p><strong>Results: </strong>Our search yielded 15 studies (3 randomized, 12 nonrandomized, N = 18,676 patients (121 early and 18,547 late seizures), 60% male, mean age 69 years) comparing 13 ASMs. Three studies had moderate and 12 had high risk of bias. Seizure recurrence was 24.8%. Compared with levetiracetam, very low-certainty evidence suggested that phenytoin was associated with higher seizure recurrences (odds ratio [OR] 7.3, 95% CI 3.7-14.5) and more adverse events (OR 5.2, 95% CI 1.2-22.9). Low-certainty evidence suggested that carbamazepine (OR 1.8, 95% CI 1.5-2.2) and phenytoin (OR 1.9, 95% CI 1.4-2.8) were associated with high drug discontinuation rates. Moderate to high-certainty evidence suggested that valproic acid (OR 4.7, 95% CI 3.6-6.3) and phenytoin (OR 8.3, 95% CI 5.7-11.9) were associated with higher mortality rates. Considering all treatments and using the GRADE approach for treatment ranking, very low-certainty evidence suggested that eslicarbazepine, lacosamide, and levetiracetam had the fewest seizure recurrences. Low to very low-certainty evidence suggested that lamotrigine had the fewest adverse events and drug discontinuations, whereas lamotrigine and levetiracetam exhibited low mortality rates with moderate-certainty evidence.</p><p><strong>Discussion: </strong>We found that levetiracetam and lamotrigine may be safe and tolerable ASMs for PSS. Despite ASM use, the seizure recurrence rate remains high in the PSS population. Owing to bias and confounding risks, these findings should be interpreted cautiously.</p><p><strong>Trial registration information: </strong>PROSPERO: CRD42022363844.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 3","pages":"e210231"},"PeriodicalIF":7.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of IV Thrombolysis for Acute Ischemic Stroke Patients With Moyamoya Disease.","authors":"Huanwen Chen, Marco Colasurdo, Mihir Khunte, Ajay Malhotra, Dheeraj Gandhi","doi":"10.1212/WNL.0000000000210243","DOIUrl":"https://doi.org/10.1212/WNL.0000000000210243","url":null,"abstract":"<p><strong>Objectives: </strong>Moyamoya disease (MMD) is a rare cerebrovascular condition, and it is a well-known risk factor of acute ischemic stroke (AIS). While IV thrombolysis (IVT) is an established treatment for patients with AIS, its efficacy and safety for patients with MMD is largely unknown.</p><p><strong>Methods: </strong>This was a large retrospective analysis of the 2016-2021 Nationwide Readmissions Database in the United States. MMD patients with AIS were included. Patients who underwent bypass surgery were excluded. Propensity score matching (PSM) was performed to match IVT patients with similar patients who were managed conservatively. The primary efficacy outcome was routine discharge to home with self-care. Safety outcomes included intracranial hemorrhage (ICH) and in-hospital mortality.</p><p><strong>Results: </strong>A total of 3,050 MMD patients with AIS were identified, of whom 214 (7.0%) were treated with IVT. After PSM, IVT patients had higher rates of routine discharge compared with those who were not treated with IVT (53.6% vs 45.1%, respectively, <i>p</i> = 0.045). IVT treatment, compared with no-IVT, was not associated with different rates of ICH (7.1% vs 10.9%, <i>p</i> = 0.58) or in-hospital mortality (3.8% vs 5.3%, <i>p</i> = 0.93).</p><p><strong>Discussion: </strong>IVT is seldom used to treat AIS in patients with MMD, and it may be effective and safe for select cases. Confirmation with prospective studies is needed.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 3","pages":"e210243"},"PeriodicalIF":7.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Response: Distribution of Silent Cerebral Infarcts in Adults With Sickle Cell Disease.","authors":"Lori C Jordan, R Sky Jones, Michael R Debaun, Andria L Ford","doi":"10.1212/WNL.0000000000209737","DOIUrl":"https://doi.org/10.1212/WNL.0000000000209737","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 2","pages":"e209737"},"PeriodicalIF":7.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progression Independent of Relapse Activity in Multiple Sclerosis: More, or Less, Than Meets the Eye?","authors":"Alessandro Cruciani, Ahmed T Toosy","doi":"10.1212/WNL.0000000000210296","DOIUrl":"https://doi.org/10.1212/WNL.0000000000210296","url":null,"abstract":"","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 2","pages":"e210296"},"PeriodicalIF":7.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Plasma p-tau217 and [¹⁸F]FDG-PET for Identifying Alzheimer Disease in People With Early-Onset or Atypical Dementia.","authors":"Kely Monica Quispialaya, Joseph Therriault, Antonio Aliaga, Andrea L Benedet, Nicholas J Ashton, Thomas Karikari, Arthur Cassa Macedo, Nesrine Rahmouni, Cécile Tissot, Jaime Fernandez Arias, Yi-Ting Tina Wang, Lydia Trudel, Seyyed Ali Hosseini, Takashi Matsudaira, Tevy Chan, Tharick Pascoal, Brian Gilfix, Paolo Vitali, Eduardo R Zimmer, Karine Provost, Jean-Paul Soucy, Serge Gauthier, Henrik Zetterberg, Bertrand J Jean-Claude, Kaj Blennow, Pedro Rosa-Neto","doi":"10.1212/WNL.0000000000210211","DOIUrl":"10.1212/WNL.0000000000210211","url":null,"abstract":"<p><strong>Background and objectives: </strong>To compare the diagnostic performance of an immunoassay for plasma concentrations of phosphorylated tau (p-tau) 217 with visual assessments of fluorine-18 fluorodeoxyglucose [¹⁸F]FDG-PET in individuals who meet appropriate use criteria for Alzheimer dementia (AD) biomarker assessments.</p><p><strong>Methods: </strong>We performed a retrospective analysis of individuals with early-onset (age <65 years at onset) and/or atypical dementia (features other than memory at onset), who were evaluated at a tertiary care memory clinic. All participants underwent measurements of CSF biomarkers (Aβ42, p-tau181, and total tau levels), as well as [¹⁸F]FDG-PET scans, amyloid-PET scans, and plasma p-tau217 quantifications. To determine whether the [¹⁸F]FDG-PET images were compatible with AD, images were visually rated by 2 nuclear medicine experts. Using a contingency analysis, we evaluated the accuracy of [¹⁸F]FDG-PET scan interpretation and plasma p-tau217 for an AD biomarker profile in CSF and for amyloid-PET positivity.</p><p><strong>Results: </strong>A total of 81 individuals with early onset and/or atypical dementia were included in this study (mean age = 65 years; 48/81 female (59%). Both [¹⁸F]FDG-PET and plasma p-tau217 showed high levels of agreement with reference standard AD biomarkers ([¹⁸F]FDG-PET area under the curve [AUC]: 71%; plasma p-tau217 AUC: 81%). Although both biomarkers had similar specificity for AD [¹⁸F]FDG-PET: 70%, CI: 0.56-0.81; plasma p-tau217: 70%, CI: 0.56-0.81), plasma p-tau217 had higher sensitivity for AD (plasma p-tau217: 97%, CI: 0.85-0.99 vs [¹⁸F]FDG-PET: 73%, CI: 0.57-0.85) (<i>p</i> = 0.01). Overall accuracy was also higher for plasma p-tau217 (AUC = 84%, CI: 0.75-0.93 vs 72%, CI: 0.60-0.83 of [¹⁸F]FDG-PET) (<i>p</i> = 0.02). The same pattern of results was observed when using amyloid-PET as the reference standard.</p><p><strong>Discussion: </strong>Our study provides evidence that plasma p-tau217 has strong discriminative accuracy for AD among patients with early-onset and/or atypical dementia assessed in specialized settings. Future work should replicate these findings in secondary care settings.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 2","pages":"e210211"},"PeriodicalIF":7.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of IV Thrombolysis With Alteplase in Patients With Vessel Occlusion in the WAKE-UP Trial.","authors":"Ivana Galinovic, Jochen B Fiebach, Florent Boutitie, Bastian Cheng, Tae-Hee Cho, Martin Ebinger, Matthias Endres, Christian Enzinger, Jens Fiehler, Ian Ford, Johannes Gregori, Matthias Günther, Robin Lemmens, Keith W Muir, N Nighoghossian, Pascal Roy, Claus Z Simonsen, Vincent N Thijs, Anke Wouters, Christian Gerloff, Götz Thomalla, Salvador Pedraza","doi":"10.1212/WNL.0000000000209871","DOIUrl":"10.1212/WNL.0000000000209871","url":null,"abstract":"<p><strong>Background and objectives: </strong>Data from randomized trials on the treatment effect of pure thrombolysis in patients with vessel occlusion are lacking. We examined data from a corresponding subsample of patients from the multicenter, randomized, placebo-controlled WAKE-UP trial to determine whether MRI-guided IV thrombolysis with alteplase in unknown-onset ischemic stroke benefits patients presenting with vessel occlusion.</p><p><strong>Methods: </strong>Patients with an acute ischemic lesion visible on MRI diffusion-weighted imaging but no marked parenchymal hyperintensity on fluid-attenuated inversion recovery images were randomized to treatment with IV alteplase or placebo. The primary end point was a favorable outcome defined by a modified Rankin Scale score of 0-1 at 90 days after stroke. We investigated the interaction between vessel status and treatment effect using an unconditional logistic regression model. Treatment effects (adjusted odds ratio [aOR]) and their 95% CI were compared in patients with and without any vessel occlusion (AVO) and large vessel occlusion (LVO).</p><p><strong>Results: </strong>185 patients (mean age 64.5 years, 46% female, median NIH Stroke Scale score 9, median time between last seen well and MRI 10.26 hours) received treatment and presented with an occlusion. 98 (20%) had LVO (defined as occlusion of the internal carotid artery, middle cerebral artery trunk, or combination). A favorable outcome was observed in 30 of 94 patients with AVO (31.9%) in the alteplase group and in 18 of 91 (19.8%) in the placebo group (aOR 2.04, 95% CI 1.00-4.18). In the subgroup of patients with LVO, a favorable outcome was observed in 16 of 53 (30.2%) in the alteplase group and in 7 of 44 (15.9%) in the placebo group (aOR 2.08, 95% CI 0.71-6.10). Treatment with alteplase was associated with higher odds of favorable outcomes with no heterogeneity of treatment effect between patients with AVO and patent vessel (<i>p</i> = 0.56), or between patients with and without LVO (<i>p</i> = 0.69).</p><p><strong>Discussion: </strong>Although the WAKE-UP study was not powered to demonstrate treatment efficacy in patient subpopulations, this subgroup analysis points to a benefit of MRI-guided thrombolysis in patients with unknown-onset ischemic stroke, independent of vessel occlusion.</p><p><strong>Clinical trial registration: </strong>Registered at ClinicalTrials.gov with unique identifier NCT01525290 (clinicaltrials.gov/study/NCT01525290). The study was first posted on February 2, 2012; the first patient was enrolled on September 24, 2012.</p><p><strong>Classification of evidence: </strong>This study provides Class II evidence that for patients with unknown-onset ischemic stroke with AVO, MRI-guided treatment with IV tissue plasminogen activator improves outcomes.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 2","pages":"e209871"},"PeriodicalIF":7.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}