Neurosurgery最新文献

{"title":"Added Value of Adjunctive Middle Meningeal Embolization to Surgical Evacuation for Chronic Subdural Hematoma: Comprehensive Meta-Analysis Based on Controlling Confounders.","authors":"S Farzad Maroufi, Mohammad Sadegh Fallahi, Sahar Afsahi, Risheng Xu, Justin M Caplan, L Fernando Gonzalez, Mark G Luciano","doi":"10.1227/neu.0000000000003588","DOIUrl":"10.1227/neu.0000000000003588","url":null,"abstract":"<p><strong>Background and objectives: </strong>Chronic subdural hematoma (CSDH) often recurs after surgical evacuation, with rates ranging from 2% to 37%. Middle meningeal artery embolization (MMAE) has emerged as a potential adjunct to surgery to reduce recurrence. The aim of this study was to systematically review the added value of adjunctive MMAE to surgical treatment (MMAE+S) compared with surgical treatment alone (S) in managing CSDH with consideration to matching and randomization status of the 2 groups.</p><p><strong>Methods: </strong>A systematic search identified 16 studies encompassing 1814 patients (939 MMAE+S, 1440 S). Five studies were randomized trials, 3 studies were matched studies, and the remaining were unmatched cohorts. Data on recurrence, radiological and functional outcomes, complications, and hospital stay were analyzed using a random-effects meta-analysis. The risk of bias was evaluated using Risk of Bias in Nonrandomized Studies of Interventions and Risk of Bias in Randomized Trials tools.</p><p><strong>Results: </strong>The 2 treatment groups were comparable regarding all preoperative characteristics except for antithrombotic use which was higher in the MMAE+S group (P = .03). Compared with surgery alone, the MMAE+S group had significantly lower recurrence rates (4.7% vs 17.7%, relative risk [RR] 0.31, P < .01) and reduced postoperative hematoma thickness (standardized mean difference [SMD] -0.17, P = .04), volume (SMD -0.25, P = .01), and midline shift (SMD -0.24, P = .01). Reduced recurrence was also observed in the subgroup of matched/randomized studies (RR 0.28, P < .01) and only randomized studies (RR 0.28, P < .01). Complication rates were comparable between the 2 groups when analyzing all (RR 0.90, P = .46), matched/randomized (RR 1.05, P = .62), and only randomized studies (RR 1.05, P = .63). The outcomes were influenced by the choice of embolic agent and timing of embolization, with liquid agents, and postoperative embolization showing slightly better outcomes compared with other embolization approaches. Functional outcomes, complications, mortality, and length of hospital stay were comparable between groups.</p><p><strong>Conclusion: </strong>MMAE combined with surgery effectively reduces CSDH recurrence and improves radiological outcomes without increasing complications. These findings support MMAE as a valuable adjunct to surgical treatment, warranting further research to optimize its clinical application.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Tanzanian Neurosurgeons Access Tanzanian Neurosurgical Literature? A Systematic Review and Survey of Neurosurgical Publications.","authors":"Romani R Sabas, Julie Woodfield, Chibuikem Anthony Ikwuegbuenyi, Magalie Cadieux, Consolata Shayo, Zarina Shabhay, Happiness Rabiel, Beverly Cheserem, Joel Bwemelo, Drew N Wright, Celestina S Fivawo, Salome M Maghembe, Kisitu Lawrence, Sengua Koipapi, Laurent Lemeri Mchome, Halinder S Mangat, Roger Hartl, Hamisi Kimaro Shabani","doi":"10.1227/neu.0000000000003570","DOIUrl":"https://doi.org/10.1227/neu.0000000000003570","url":null,"abstract":"<p><strong>Background and objectives: </strong>Free and open access to research data and findings promotes equity in access to healthcare knowledge and equity in patient care and treatment. To benefit the health care of the population studied, research findings must be accessible to clinicians, academics, and policymakers serving those populations. The aim of this study was to assess the extent of published Tanzanian neurosurgical data and its accessibility to those practicing within the country.</p><p><strong>Methods: </strong>A systematic review of all published neurosurgical studies from Tanzania was conducted. Authorship, funding, and open-access status were recorded. Tanzanian neurosurgeons were surveyed by telephone or in person about their methods of accessing literature.</p><p><strong>Results: </strong>We identified 96 Tanzanian neurosurgical studies published in 42 journals between 1982 and 2023 with an exponentially increasing number of publications per year. Fifty-nine studies (62%) are available open access at the publisher. Open access publication is associated with Tanzanian first authorship (odds ratio = 2.6, 95% CI: 1.0-6.8) or last authorship (odds ratio = 2.7, 95% CI: 1.0-7.1). However, overall only 34 of 96 studies (35%) had Tanzanian first authors and 32 of 96 (33%) had Tanzanian last authors. We contacted 26 of 27 neurosurgeons working in Tanzania. None had in-country institutional library service access. One used a research initiative login to access neurosurgical literature, and 2 used institutional logins from outside Tanzania. Ten neurosurgeons (38%) reported alternative methods of accessing literature behind a paywall such as Sci-Hub or direct contact with authors. These methods could have given access to all but 9 of 96 neurosurgical studies (9%).</p><p><strong>Conclusion: </strong>Only 62% of Tanzanian neurosurgical literature is easily freely accessible to Tanzanian neurosurgeons, and 9% of all Tanzanian neurosurgical literature is extremely challenging to access for neurosurgeons working in Tanzania. Expanding open-access publishing, repositories, and publisher and institutional initiatives for equitable data and publication access are crucial for improving access to local data to improve patient care.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reply: Does Mechanism of Injury Affect Recovery After Sport-Related Concussion in Basketball? A Pilot Study.","authors":"Anthony E Bishay, Avi N Albert, Grant H Rigney, James T Corley, Kristen L Williams, Jacob Jo, Douglas P Terry, Scott L Zuckerman","doi":"10.1227/neu.0000000000003598","DOIUrl":"https://doi.org/10.1227/neu.0000000000003598","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventriculoatrial Shunt Versus Ventriculoperitoneal Shunt: A Systematic Review and Meta-Analysis: Corrigendum.","authors":"Leonardo B O Brenner, Fernando Hakim, Gabriel da Silva Semione, Raphael Bertani, Sávio Batista, Lucca B Palavani, Marcelo Porto Sousa, Diego F Gómez-Amarillo, Isabella Mejía-Michelsen, Fernando Campos Gomes Pinto, Nicollas Nunes Rabelo, Leonardo C Welling, Eberval Gadelha Figueiredo","doi":"10.1227/neu.0000000000003603","DOIUrl":"10.1227/neu.0000000000003603","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":"e70"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes After Stereotactic Radiosurgery for Intracranial Hemangioblastoma in Von Hippel-Lindau Disease and Sporadic Cases: An International Multicenter Study.","authors":"Ahmed Shaaban, Salem M Tos, Georgios Mantziaris, Duy Pham, Sam Dayawansa, Ahmed M Nabeel, Wael A Reda, Sameh R Tawadros, Khaled Abdel Karim, Amr M N El-Shehaby, Reem M Emad, Zhishuo Wei, Lindsay M McKendrick, Ajay Niranjan, L Dade Lunsford, Selcuk Peker, Yavuz Samanci, Roman Liscak, Jaromir May, David Mathieu, Cheng-Chia Lee, Huai-Che Yang, Antonio Dono, Angel I Blanco, Yoshua Esquenazi, Nuria Martinez Moreno, Roberto Martinez Álvarez, Piero Picozzi, Andrea Franzini, Manjul Tripathi, Takuma Sumi, Takeo Uzuka, Hideyuki Kano, David Bailey, Brad E Zacharia, Christopher P Cifarelli, Daniel T Cifarelli, Joshua D Hack, Herwin Speckter, Erwin Lazo, Ronald E Warnick, Jonathan E Schoenhals, Joshua D Palmer, Ashok R Asthagiri, Zhiyuan Xu, Jason P Sheehan","doi":"10.1227/neu.0000000000003579","DOIUrl":"https://doi.org/10.1227/neu.0000000000003579","url":null,"abstract":"<p><strong>Background and objectives: </strong>Hemangioblastomas (HGBs) are rare, benign, World Health Organization grade 1 vascular tumors, which are most commonly located in the cerebellum, and may occur sporadically or in association with von Hippel-Lindau (VHL) disease, a hereditary VHL-mutated tumor syndrome. Limited data are available regarding factors affecting outcomes after stereotactic radiosurgery (SRS). We aim to provide a contemporary evaluation of SRS for HGBs through an international, multicenter study. In this study, we assess local tumor control and SRS-related complications in patients with intracranial HGBs.</p><p><strong>Methods: </strong>A retrospective analysis from 17 centers was performed. Data on patient characteristics, SRS parameters, and outcomes were collected. The study included 104 patients with VHL and 89 sporadic cases, with 433 and 137 tumors, respectively. The median follow-up after the initial SRS was 52 months for patients with VHL and 44 months for sporadic cases.</p><p><strong>Results: </strong>At the last follow-up, tumor control was achieved in 85% of VHL tumors and 76% of sporadic tumors. Radiation-induced changes were identified in 13 (3.5%) VHL cases and 5 (3.8%) sporadic cases. The overall 3-year and 5-year cumulative incidences of tumor progression were 13% and 22% for all tumors, 14% and 25% for VHL, and 13% and 17% for sporadic cases. Tumor progression was more common in cystic than in solid tumors in the sporadic group. Overall survival probability and progression-free survival were better in VHL cases compared with the sporadic group. Older age at SRS, male sex, and multiple tumors were associated with reduced local tumor control in all tumors and in the VHL group, whereas a margin dose >15 Gy was associated with improved local tumor control in both groups.</p><p><strong>Conclusion: </strong>SRS offers an effective treatment of intracranial HGBs, whether VHL-associated or sporadic, with a favorable risk profile. HGBs without a cystic component were more likely to be controlled after SRS in the sporadic group.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Does Mechanism of Injury Affect Recovery After Sport-Related Concussion in Basketball? A Pilot Study.","authors":"Rob Dickerman, Matthew Bennett, Sterling Ortega","doi":"10.1227/neu.0000000000003597","DOIUrl":"https://doi.org/10.1227/neu.0000000000003597","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter: Traumatic Vertebral Artery Injury After Subaxial Cervical Spine Injuries: Incidence, Risk Factors, and Long-Term Outcomes: A Population-Based Cohort Study.","authors":"Xin Zhou","doi":"10.1227/neu.0000000000003599","DOIUrl":"https://doi.org/10.1227/neu.0000000000003599","url":null,"abstract":"","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multicenter Study of Noninvasive Wireless Assessment of Cerebrospinal Fluid Shunt Function in Hydrocephalus Patients.","authors":"David D Limbrick, Jesse Skoch, Kurtis Auguste, Gerald A Grant, Sandi K Lam, Matthew C Tate, David J Langer, Jarod L Roland, Tord D Alden, Fady T Charbel, Robert M Lober, Keith Patten, Elaine Kennedy, Caroline Farless, Samantha Himsworth, Rachel Fasbender, Linda Lovell-Ewen, Diego M Morales, Chase F Correia, Alex Burton, Jenna E Koschnitzky, R Chad Webb, Adam M Zysk","doi":"10.1227/neu.0000000000003569","DOIUrl":"https://doi.org/10.1227/neu.0000000000003569","url":null,"abstract":"<p><strong>Background and objectives: </strong>Diagnosis of cerebrospinal fluid (CSF) shunt failure is complex, relying on a combination of patient symptoms, history, and indirect tests, in part due to the inability to easily access information about shunt function. The objective of this study was to evaluate the performance of a novel noninvasive wearable wireless device in assessing the presence of shunt flow in patients presenting with possible shunt failure.</p><p><strong>Methods: </strong>This was a prospective validation study including patients with an existing implanted CSF shunt system and symptoms of possible shunt failure. Subjects underwent evaluation with the study device in addition to standard-of-care evaluation. Device measurement data were evaluated with 2 algorithms and classified as \"flow confirmed\" or \"flow not confirmed.\" Subjects were followed for 7 days and, in patients undergoing shunt surgery, intraoperative assessment of shunt functionality established the presence or absence of complete shunt failure. Additional subjects were enrolled for user training and algorithm development.</p><p><strong>Results: </strong>In total, the study device was used on 182 subjects for user training, algorithm development, and validation. The final algorithm validation data set included 112 subjects. The random forest algorithm outperformed the binary threshold algorithm. The sensitivity of the random forest algorithm (correct identification of complete shunt failure) was 88.9%, and the specificity (correct identification of an absence of complete shunt failure) was 49.2% with a negative predictive value of 96.8%.</p><p><strong>Conclusion: </strong>This study established the performance of a first-generation wearable thermal anisotropy sensor in the identification of CSF shunt flow in symptomatic patients. The high negative predictive value suggests potential application to identify flowing shunts. Additional device performance and clinical outcome studies are underway.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Clinical Variables and Aneurysm Morphology on Hemorrhage Volume and Clinical Outcomes.","authors":"Andres Gudino, Elena Sagues, Carlos Dier, Sebastian Sanchez, Martin Cabarique, Navami Shenoy, Alexander Van Dam, Linder Wendt, Connor Aamot, Santiago Ortega-Gutierrez, Mario Zanaty, Edgar A Samaniego","doi":"10.1227/neu.0000000000003567","DOIUrl":"10.1227/neu.0000000000003567","url":null,"abstract":"<p><strong>Background and objectives: </strong>It is unknown what determines the volume of aneurysmal subarachnoid hemorrhage (aSAH). We aimed to investigate the features associated to the burden of subarachnoid hemorrhage after aneurysm rupture and its impact on clinical outcomes.</p><p><strong>Methods: </strong>Patients admitted with aSAH between 2009 and 2022 were included. Clinical data were obtained from electronic medical records. Aneurysm location and morphological measurements were assessed using digital subtraction angiography. aSAH volume was objectively quantified on admission noncontrast computed tomography using semiautomated software. Univariate and multivariate analyses were performed to identify predictors of hemorrhage volume and examine its association with delayed cerebral ischemia (DCI), clinical vasospasm, and 7-day mortality in younger (18-64 years) and elderly (≥65 years) patients.</p><p><strong>Results: </strong>Two hundred ruptured intracranial aneurysms were analyzed. Ruptured bifurcating aneurysms exhibited larger hemorrhage volume compared with sidewall aneurysms (23.16 mL, IQR: 34.2 vs 11.95 mL, IQR: 20.9, P = .002). In multivariate analysis, age (exp β 1.02; 95% CI 1.01-1.03; P < .001), Hunt and Hess (exp β 1.46, 95% CI: 1.31-1.62, P <.001), and bifurcation aneurysms (exp β 1.76; 95% CI 1.37-2.26; P <.001) were correlated with increased aSAH volume. Among younger patients, higher aSAH volume was associated with DCI (odds ratio [OR] 1.04; 95% CI 1.02-1.06; P < .001), clinical vasospasm (OR 1.02; 95% CI 1.01-1.03; P = .02), and 7-day mortality (OR 1.05; 95% CI 1.02-1.07; P < .001). In elderly population, larger aSAH was only associated with 7-day mortality (OR 1.04; 95% CI 1.01-1.07; P = .01).</p><p><strong>Conclusion: </strong>Older age, bifurcating aneurysms, and higher Hunt and Hess are associated with larger aSAH volumes. In younger patients, greater aSAH volume is linked to an increased risk of DCI, clinical vasospasm, and 7-day mortality. Among older patients, increased aSAH volume is only associated with 7-day mortality.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feeder Artery Aneurysms in Cerebral Arteriovenous Malformations: Demographic, Clinical, and Morphological Associations.","authors":"Tatiana Abou-Mrad, Laura Stone McGuire, Peter Theiss, Jessica Hossa, Richard Bram, Clairice Pearce, Mpuekela Tshibangu, Adrusht Madapoosi, Fady T Charbel, Ali Alaraj","doi":"10.1227/neu.0000000000003568","DOIUrl":"https://doi.org/10.1227/neu.0000000000003568","url":null,"abstract":"<p><strong>Background and objectives: </strong>Cerebral arteriovenous malformations (AVMs) represent complex vascular lesions with variable anatomical characteristics. The coexistence of feeder artery aneurysms (FAAs) with AVMs adds an additional layer of complexity, influencing patient outcomes and treatment strategies.</p><p><strong>Methods: </strong>A retrospective review of patients evaluated for cerebral AVMs at our institution from 2000 to 2024 was conducted. Patient demographics, as well as AVM angioarchitectural and hemodynamic parameters were collected and compared between AVMs with and without FAAs. Logistic regression identified independent predictors of FAA presence, and subgroup analyses explored the relationship between FAA presence, rupture presentation, and AVM characteristics.</p><p><strong>Results: </strong>Four hundred thirty-one patients with cerebral AVMs were included. FAAs were present in 20.0% of AVMs and were associated with older age (P < .001), infratentorial location (P < .001), larger feeder artery diameter (P = .001), and hemorrhagic presentation (P = .002). Logistic regression showed 6× higher odds for FAA in infratentorial AVMs (P < .001), and subgroup analysis of infratentorial AVMs showed smaller volume (P = .016), smaller feeder size (P < .001), and less draining veins (P < .001) in comparison with supratentorial location. Among ruptured AVMs, FAA-related ruptures occurred in older patients (P = .004), were more common in infratentorial AVMs (P < .001), and were associated with smaller AVM volumes (P = .012), posterior circulation FAAs (P = .044), and deep venous drainage (P = .037). Hypertension (P = .003) and distal FAAs (P = .036) were more prevalent in FAA-related ruptures, whereas venous stenosis was more frequent in AVM-related ruptures (P = .050).</p><p><strong>Conclusion: </strong>FAAs are associated with distinct angioarchitectural features, particularly in infratentorial AVMs, and are also linked to rupture presentation. Given their unique hemodynamic and anatomical profile, AVMs with FAAs may warrant closer surveillance and a more aggressive treatment approach to mitigate rupture risk and improve patient outcomes.</p>","PeriodicalId":19276,"journal":{"name":"Neurosurgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}