Ophthalmic Plastic and Reconstructive Surgery最新文献

{"title":"Tocilizumab Treatment for Early Active-Phase Thyroid Eye Disease.","authors":"Celestine H Gregerson, Katherine G Nickerson, Michael Kazim","doi":"10.1097/IOP.0000000000003289","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003289","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of tocilizumab as a primary treatment and with bridge corticosteroid treatment for early active-phase thyroid eye disease (TED).</p><p><strong>Methods: </strong>A single-center observational study was conducted among adult patients with treatment-naïve TED who initiated tocilizumab infusions (8 mg/kg administered monthly) within 9 months of developing the signs or symptoms of the disease. Primary outcomes were proptosis reduction and relapse rate. Secondary outcomes included resolution of lid edema, improvement in extraocular motility restriction, improvement in TED-associated compressive optic neuropathy, and incidence of side effects or adverse events.</p><p><strong>Results: </strong>Among 23 patients studied, 24 orbits from 12 patients met inclusion criteria. The mean duration of active TED at initial consultation was 3.5 months, and prior to treatment was 5.3 months. Seven patients (58%) received tocilizumab monotherapy, and 5 patients (42%) received oral prednisone bridge followed by tocilizumab infusions. An average of 6.4 tocilizumab infusions were received. Mean proptosis reduction was 3.2 mm (p < 0.001), with proptosis reduction ≥2 mm seen in 18 orbits (75%, p < 0.001). TED-associated compressive optic neuropathy was present in 7 orbits prior to treatment, and all affected orbits (100%) demonstrated improvement or resolution with treatment (p = 0.02). No statistical difference in outcome measures was found between the monotherapy and bridge therapy groups. The mean follow-up interval after completion of tocilizumab treatment was 10 months (range, 4-22; median 9). Relapse was seen in 1 patient. Tocilizumab infusions were well-tolerated, and adverse events were rare.</p><p><strong>Conclusions: </strong>Tocilizumab shows promise as an effective and well-tolerated first-line treatment option as either monotherapy or following a corticosteroid bridge for early active-phase TED.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Vertical Tarsotomy Technique: Serial Tarsotomies Enable Direct Closure of Moderate-to-Large Full-Thickness Eyelid Defects.","authors":"Simerdip Kaur, Raman Malhotra","doi":"10.1097/IOP.0000000000003308","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003308","url":null,"abstract":"<p><strong>Background: </strong>Direct closure of eyelid defects is traditionally limited to small defects of less than a third of the horizontal eyelid length due to concern regarding distortion of the palpebral aperture and risk of eyelid malposition. We describe a simple, reproducible technique using serial vertical full-thickness tarsotomy incisions to lengthen the residual eyelid. This facilitates direct closure of larger defects, avoiding the need for Tenzel, Macgregor, and in selected cases, even Hughes flaps.</p><p><strong>Methods: </strong>Single-center retrospective case series of patients undergoing eyelid reconstruction following periocular tumor excision. Serial vertical full-thickness tarsotomies were performed in the residual tarsus to increase eyelid length and facilitate direct closure. Patient demographics, tumor characteristics, defect size, reconstructive techniques, and complications were recorded.</p><p><strong>Results: </strong>Ten patients were included with a mean age of 78.5 years (range 65-93). Six (60%) patients were female, and basal cell carcinoma accounted for 90% of tumors. The lower eyelid was involved in 80% of cases. Defects ranged from one-third to two-thirds of the horizontal eyelid length, with the majority (70%) involving more than half of the eyelid. Additionally, internal lateral cantholysis was performed in 8 cases, and direct closure was achieved in all cases. Mean follow-up was 8.1 (range 5-17) months. Postoperative complications occurred in 3 patients, including corneal irritation requiring temporary bandage contact lens wear (n = 1) and mild ectropion (n = 2). There were no cases of wound dehiscence or sight-threatening complications.</p><p><strong>Conclusion: </strong>Serial vertical tarsotomies represent a unique technique to increase eyelid length and facilitate direct closure of moderate-to-large eyelid margin defects. This approach offers favorable functional and aesthetic outcomes and may represent a new reconstructive option in the management of full-thickness eyelid defects.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Identification of Ecthyma Gangrenosum on the Eyelid Margin.","authors":"Maya T Harrington, Rachel K Sobel","doi":"10.1097/IOP.0000000000003296","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003296","url":null,"abstract":"<p><p>Ecthyma gangrenosum is an uncommon cutaneous manifestation of Pseudomonas aeruginosa bacteremia, and even more rarely occurs in the periorbital region. Only a handful of prior case reports discuss lesions on the eyelid, often describing cases with rapid progression of necrosis requiring aggressive debridement. This series describes 2 cases of Pseudomonas-positive ecthyma gangrenosum on the eyelid margin in neutropenic patients, which were identified within 24 hours of lesion onset. Both cases were medically managed with rapid resolution of neutropenia and systemic anti-pseudomonal antibiotics, with no need for surgical debridement.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parasitic Infections of the Lacrimal System: A Major Review of Etiology, Clinical Presentation, and Management.","authors":"Yasaman Salari, Valerie Juniat, Mohammad Javed Ali","doi":"10.1097/IOP.0000000000003305","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003305","url":null,"abstract":"<p><strong>Purpose: </strong>Parasitic infections of the lacrimal system are rare and often under-recognized causes of lacrimal pathology. Their clinical presentation frequently mimics more common conditions such as chronic dacryocystitis, leading to diagnostic challenges and delays in appropriate management. This study aims to systematically review the literature on parasitic infections of the lacrimal system and to characterize their etiology, clinical presentation, diagnostic approaches, management strategies, and outcomes.</p><p><strong>Methods: </strong>A systematic review was conducted across MEDLINE, Embase, Emcare, and PubMed from inception to March 2026. Studies reporting parasitic infections involving the lacrimal apparatus were included. Data on demographics, clinical presentation, anatomical involvement, causative organisms, diagnostic methods, treatment, and outcomes were extracted. Due to heterogeneity and predominance of case reports and small series, a qualitative descriptive analysis was performed.</p><p><strong>Results: </strong>A total of 44 studies comprising 172 cases were included. Rhinosporidium seeberi was the most frequently reported pathogen, accounting for 147 cases (85.5%), followed by Leishmania (8 cases, 4.7%) and Ascaris lumbricoides (7 cases, 4.1%). The lacrimal sac was the most commonly involved site. Clinical presentation was nonspecific, with epiphora and medial canthal swelling predominating. Diagnosis was most often established by histopathology following surgical intervention. Management varied by etiology, with surgical excision commonly used for rhinosporidiosis and mechanical extraction for helminthic infections. Outcomes were generally favorable, although recurrence was reported, particularly in R. seeberi infections.</p><p><strong>Conclusions: </strong>Parasitic infections of the lacrimal system are rare but clinically important, with diverse presentations and management approaches. Increased awareness is essential for early diagnosis and appropriate treatment. Further studies with standardized reporting are needed to optimize management strategies.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Literature-Specific Artificial Intelligence: Analyzing the performance of OpenEvidence, Heidi Evidence, Consensus, and PubMed.ai in the context of Lacrimal Drainage Disorders.","authors":"Mohammad Javed Ali, Bobby S Korn","doi":"10.1097/IOP.0000000000003302","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003302","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to report the performance of medical literature-specific artificial intelligence (MLS-AI) deep learning tools in the context of lacrimal drainage disorders.</p><p><strong>Methods: </strong>Prompt engineering was performed using 22 previously validated questions and statements to include common and rare aspects of lacrimal drainage disorders. Prompts were presented at least twice to the latest versions of OpenEvidence, Heidi Evidence, Consensus, and PubMed.ai [Accessed May 14-26, 2026]. The prompts included general queries, such as the management of congenital nasolacrimal duct obstructions, as well as specific queries, such as the terminology of idiopathic canalicular inflammatory disease or a history of dacryocystorhinostomy surgery. The MLS-AI were also quizzed on controversial topics, such as the use of silicone intubation and mitomycin-C in dacryocystorhinostomy. The responses were assessed for overall quality, organization, and clarity, evidence-based content, updated knowledge, specific responses, speed, and factual inaccuracies. The responses were graded by the authors as correct, partially correct, and factually incorrect.</p><p><strong>Results: </strong>The overall performance of OpenEvidence and Heidi was comparable in the context of lacrimal drainage disorders. However, Heidi hallucinated twice, giving OpenEvidence an edge over Heidi. Consensus came in a close third largely due to the quality of its responses. There is much to be desired from the performance of PubMed.ai. In terms of response accuracy, the MLS-AI models performed differently. OpenEvidence's responses were graded as correct in 90.9% (20/22), and partially correct in 9.1% (2/22), with no factually incorrect responses. Heidi's responses were graded as correct in 63.6% (14/22), partially correct in 31.8% (7/22), and factually incorrect in 4.6% (1/22). In comparison, the responses of Consensus were graded as correct in 54.5% (12/22), partially correct in 40.9% (9/22), and factually incorrect in 4.6% (1/22). PubMed.ai was the worst-performing MLS-AI, with 45.5% partially correct responses, 22.7% (5/22) factually incorrect answers, and 9% (2/22) with no response.</p><p><strong>Conclusion: </strong>OpenEvidence has a slight edge over Heidi Evidence. PubMed.ai is lagging far behind the other 3 tools. Each of the MLS-AI tools had unique advantages and could complement one another based on context and prompt type. They need to be specifically trained further to capture more indexed mainstream journal publications. All MLS-AI responses at present should have human oversight and verification before they are accepted as true.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lash Ptosis and Entropion after Congenital Ptosis Surgery: Mechanisms and Treatment.","authors":"Mostafa M Diab, Richard C Allen","doi":"10.1097/IOP.0000000000003303","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003303","url":null,"abstract":"<p><strong>Purpose: </strong>This perspective proposes a clinically useful framework for understanding upper eyelid lash ptosis and entropion after congenital ptosis surgery, linking potential mechanisms to prevention and management.</p><p><strong>Methods: </strong>A focused literature review was performed.</p><p><strong>Results: </strong>Postoperative lash ptosis and entropion likely reflect the differential interplay of multiple biomechanical factors: lamellar imbalance, suboptimal fixation geometry, tarsal buckling, excessive pretarsal dissection, and patient-specific predisposition, rather than a single technical error. Understanding these mechanisms may help surgeons anticipate risk, refine prevention, and tailor surgical management.</p><p><strong>Conclusions: </strong>Lash ptosis and entropion after congenital ptosis surgery are likely multifactorial complications resulting from altered eyelid biomechanics. A mechanism-based understanding of these conditions may improve surgical planning and intraoperative decision-making. Further biomechanical and clinical studies are needed to validate this framework and optimize preventive and corrective strategies.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periorbital Fat Atrophy With Topical Bimatoprost in Glaucoma, Ocular Hypertension, and Cosmetic Use: Systematic Review and Meta-Analysis.","authors":"Laila Sheather, Zeena Kailani, Aljeena Rahat Qureshi, Zaynab Somani, Sangsu Han, Sohel Somani","doi":"10.1097/IOP.0000000000003276","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003276","url":null,"abstract":"<p><strong>Purpose: </strong>To synthesize evidence on bimatoprost-associated periorbital fat atrophy, compare outcomes across prostaglandin analogues, and evaluate reversibility after discontinuation.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched from inception to August 2025 according to an a priori protocol (International Prospective Register of Systematic Reviews CRD420251107027). Studies evaluating periorbital structural changes in human subjects using topical bimatoprost for glaucoma, ocular hypertension, or cosmetic indications were included. Risk of bias was assessed using Joanna Briggs Institute tools. Random-effects meta-analyses estimated risk ratios comparing bimatoprost with latanoprost and travoprost for deepening of the upper eyelid sulcus, periorbital fat loss, enophthalmos, and dermatochalasis involution.</p><p><strong>Results: </strong>Forty-five studies comprising 7,106 participants (3,176 bimatoprost-exposed) were included. Meta-analysis of five comparative studies (742 eyes) demonstrated a significantly higher risk of deepening of the upper eyelid sulcus (risk ratio, 2.92 [95% CI, 1.98-4.30]; Grading of Recommendations Assessment, Development, and Evaluation = low) and periorbital fat loss (risk ratio, 3.10 [95% CI, 1.07-8.99]; Grading of Recommendations Assessment, Development, and Evaluation = very low) with bimatoprost versus latanoprost. No significant differences were observed between bimatoprost and travoprost for any outcome (Grading of Recommendations Assessment, Development, and Evaluation = very low). Reversibility was variable; deepening of the upper eyelid sulcus showed the greatest resistance to recovery.</p><p><strong>Conclusions: </strong>Bimatoprost carries a significantly elevated risk of periorbital fat atrophy compared with latanoprost, with nearly three-fold increased risk; however, the certainty of evidence is low to very low. Bimatoprost and travoprost demonstrate equivalent periorbital adverse effect profiles, suggesting that switching between them is unlikely to reduce periorbital effects. These findings support the preferential use of latanoprost when periorbital appearance is a priority. Limitations include heterogeneity in outcome assessment and predominance of observational designs.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inverted Papilloma Presenting as Orbital Cellulitis and Dacryocystitis.","authors":"Michelle C Ho, Emily S Mei, Celestine H Gregerson, Gary Lelli","doi":"10.1097/IOP.0000000000003300","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003300","url":null,"abstract":"<p><p>A 66-year-old female with a past medical history of psoriasis and chronic sinusitis presented with left orbital pain, proptosis, ptosis, and blurry vision, concerning for orbital cellulitis. Imaging revealed an enhancing soft tissue mass centered in the left anterior ethmoid cavity with extension into the nasolacrimal duct, with associated osseous erosion and orbital inflammatory changes consistent with ipsilateral orbital cellulitis. Endoscopic surgical resection was performed, and histopathology confirmed inverted papilloma without high-grade dysplasia or carcinoma. While orbital involvement has been described in prior reports, presentation with secondary infectious complications such as orbital cellulitis is rare. This case expands the limited, yet growing, body of literature on the various clinical presentations of orbital inverted papilloma.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kikuchi-Fujimoto Disease Presenting as Refractory Eyelid Lesions Mimicking Chalazia.","authors":"May A Ameri, George A Villatoro, Patricia Chevez-Barrios, Richard C Allen","doi":"10.1097/IOP.0000000000003298","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003298","url":null,"abstract":"<p><p>Kikuchi-Fujimoto disease is a rare, benign, self-limited inflammatory disorder characterized by necrotizing lymphadenitis. Ocular manifestations are uncommon, and periocular involvement is rare. We report a 16-year-old male with a remote history of biopsy-proven Kikuchi-Fujimoto disease who presented with a 2-year history of recurrent left upper and lower eyelid lesions clinically diagnosed as chalazia. Despite multiple incision and drainage procedures, the lesions recurred and were associated with progressive eyelid thickening and mechanical ptosis. Magnetic resonance imaging demonstrated diffuse cervical, parotid, and supraclavicular lymphadenopathy with enhancement of the lacrimal glands and eyelids. Biopsy of the eyelid lesions demonstrated necrotizing lymphohistiocytic inflammation with characteristic histopathologic and immunohistochemical findings supporting extranodal Kikuchi-Fujimoto disease and excluding lymphoma, chalazia, or infection. Following incisional biopsy and intralesional corticosteroid injection, the patient demonstrated marked clinical improvement without recurrence at postoperative month 1. To our knowledge, this represents the first reported case of Kikuchi-Fujimoto disease presenting as chronic eyelid lesions mimicking chalazia and further expands the spectrum of ophthalmic manifestations associated with this uncommon disease.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eosinophilic Granulomatosis With Polyangiitis in a Pediatric Patient With Bilateral Lacrimal Gland Swelling.","authors":"Steven P Isherwood, Hardeep Singh Mudhar, Raghavan Sampath, Antonella Berry-Brincat","doi":"10.1097/IOP.0000000000003297","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003297","url":null,"abstract":"<p><p>A 2-year-old male presented to ophthalmology following a short admission for dacryoadenitis, with a background of 6 months of bilateral fluctuating upper lid swelling, obstructive airway disease, and enlarged tonsils. He had been treated for an allergy-related disease with little effect and, post-hospital discharge, continued in a similar fashion as prior. Given the poor response to escalating allergy medication, a biopsy was taken from the right lacrimal gland. This demonstrated an eosinophil-rich small vessel vasculitis with extravascular eosinophilic granulomas, consistent with a diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg-Strauss syndrome. The patient was placed on a tapering course of steroids and started on long-term mycophenolate immunosuppression. To our knowledge, this patient is the youngest case of EGPA with orbital involvement. The case and its heterogeneous presentation add to the growing knowledge of this rare condition.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}