Ophthalmic Plastic and Reconstructive Surgery最新文献

{"title":"Is Cataract Surgery a Risk Factor for New-Onset Thyroid Eye Disease?","authors":"Jawad Muayad, Masih Ahmed, Amina I Malik","doi":"10.1097/IOP.0000000000003218","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003218","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether cataract surgery is a risk factor for developing new-onset thyroid eye disease in patients with preexisting thyroid disorders using a large, population-level database.</p><p><strong>Methods: </strong>The study utilized a large database of deidentified electronic health records. Patients who underwent cataract extraction were divided into 2 cohorts and were balanced using propensity score matching for demographic factors and comorbidities, including age, sex, race, diabetes mellitus, hyperlipidemia, and nicotine dependence. The incidence of thyroid eye disease-related outcomes was assessed at 3-time intervals following the surgery date: up to 3 months, 3-6 months, and 6-12 months. The need for orbital decompression surgery was also assessed. A secondary sensitivity analysis was conducted for patients with hyperthyroidism.</p><p><strong>Results: </strong>After propensity score matching, 87,179 pairs were analyzed. Patients with thyroid disease had a significantly higher risk for the composite thyroid eye disease outcome at all time intervals: 0-3 months (risk ratio [RR]: 1.30, 95% confidence interval [CI]: 1.12-1.51), 3-6 months (RR: 1.30, 95% CI: 1.12-1.51), and 6-12 months (RR: 1.51, 95% CI: 1.33-1.71). The risk was even more pronounced in the hyperthyroid subgroup (n = 8,381), reaching a 103% increased risk at 6-12 months (RR: 2.03, 95% CI: 1.39-2.95). While no significant difference was observed for orbital decompression surgery in the immediate postoperative period, a significantly increased risk emerged at the 6-12-month interval (RR: 1.59, 95% CI: 1.13-2.24).</p><p><strong>Conclusions: </strong>Cataract surgery is associated with a significantly increased risk of developing thyroid eye disease-related outcomes in patients with underlying thyroid disease. While the overall incidence may be low, the potential consequences can be serious, highlighting the importance of clinical awareness, patient counseling, and close postoperative monitoring for this at-risk population.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777880","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":"Preoperative Ptosis Evaluation: A Comparative Analysis of Phenylephrine Drops and Eyelid Taping for Visual Field Testing.","authors":"Mannat Kaur, Lynn A Leveille, Chris R Alabiad, Andrew J Rong, Sara T Wester","doi":"10.1097/IOP.0000000000003204","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003204","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare the efficacy of phenylephrine 2.5% ophthalmic solution versus traditional upper eyelid taping in evaluating surgical need and insurance reimbursement eligibility for patients with visually significant ptosis.</p><p><strong>Methods: </strong>This single-arm, sequential study included 27 eyes with ptosis. Eyes were evaluated under 3 testing conditions: at baseline, after manual eyelid taping, and post phenylephrine instillation. The outcome measures were change in margin reflex distance 1 and superior visual field, assessed using tangent screen VF testing. Participants completed a poststudy questionnaire evaluating their experience.</p><p><strong>Results: </strong>Margin reflex distance 1 increased from a mean baseline of 0.83 mm to 2.17 mm after phenylephrine (mean improvement 1.33 mm, 95% confidence interval: 1.09-1.57 mm, p < 0.001). Mean VF improved from 6.85° to 21.77° with taping and to 22.56° with phenylephrine. The insurance criterion (≥12° increase) was met in 88.8% of eyes with taping and 92.5% of eyes with phenylephrine, with no significant difference in the proportion of eyes meeting criteria ( p = 1.000). Margin reflex distance 1 and VF changes after phenylephrine instillation showed no positive correlation (rs = 0.13, p > 0.05). Patient satisfaction scores were higher with phenylephrine (4.26 ± 0.81) compared with manual taping (3.67 ± 0.48 (mean difference 0.59, p < 0.001).</p><p><strong>Conclusions: </strong>Phenylephrine 2.5% ophthalmic solution provides comparable visual field improvements and significantly higher patient satisfaction compared with manual upper eyelid taping for preoperative VF testing in the context of insurance reimbursement eligibility for patients with ptosis.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05890027.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777896","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":"When the Eyelid Beats: A Possible Variant of Wyburn-Mason Syndrome Without Retinal Angioma.","authors":"Ali Aghajani, Saeed Rezaie Mahyari, Farshad Afshar, Bahram Eshraghi","doi":"10.1097/IOP.0000000000003210","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003210","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691414","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":"Anaphylactic Shock During Oculofacial Plastic Surgery in a Patient With Midazolam and Tetracaine Allergies.","authors":"Rupin N Parikh, Dustin Lode, Brian K Gehlbach, Amy M Yoder Dowden, Erin M Shriver","doi":"10.1097/IOP.0000000000003216","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003216","url":null,"abstract":"<p><p>Anaphylactic shock is a rare but life-threatening perioperative emergency characterized by bronchospasm, hypoxia, and hypotension. A 56-year-old woman underwent elective oculofacial plastic surgery and developed anaphylactic shock shortly after exposure to tetracaine eye drops; intravenous sedation with midazolam and propofol; and a local anesthetic mixture of lidocaine, bupivacaine, and epinephrine. Initial signs included facial flushing, hypotension, and oxygen desaturation. Intubation, epinephrine, steroid, and intensive care unit transfer were required. Blood tryptase drawn 2.5 hours after the onset of symptoms was within normal range, but subsequent allergy testing revealed positive reactions to both midazolam and tetracaine. The patient fully recovered and was discharged the following day. She underwent successful surgery 6 months later under general anesthesia. This case underscores the importance of early recognition of anaphylactic shock and the necessity of procedure rooms being well equipped to intervene. Vigilance is necessary even with agents not commonly associated with anaphylactic shock.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634062","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":"Tragal Cartilage Contouring During Facelift Surgery: A Novel Technique for Prevention of Postoperative Tragal Distortion.","authors":"Nicole B Duncan, Karen Brown, Tanuj Nakra","doi":"10.1097/IOP.0000000000003214","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003214","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a novel technique of tragal cartilage contouring during facelift surgery and evaluate its effectiveness in preserving tragal contour and preventing postoperative tragal deformities.</p><p><strong>Methods: </strong>A retrospective chart review was performed of patients who underwent rhytidectomy with tragal cartilage contouring between January 2022 and December 2023 by a single surgeon. Following flap elevation and repositioning, the cephalic tragal rim was trimmed, vertically scored, then contoured with a horizontal mattress suture to support a convex surface postoperatively. Overlying soft tissue was anchored to the superficial musculoaponeurotic system to reduce tension. Standardized pre- and postoperative photographs were evaluated by 3 independent, blinded, oculoplastic surgeons using a 4-point Likert scale to assess tragal contour, peritragal contour, scar visibility, and overall aesthetic result. Patients also provided subjective ratings of their aesthetic outcome.</p><p><strong>Results: </strong>Twenty-eight patients (24 women, 4 men; mean age 62 years, range 51-74) were included, with a mean follow-up of 8 months (range, 4-12). Independent reviewers rated all tragal contour outcomes as \"good\" or \"excellent,\" with no cases rated \"fair\" or \"poor.\" All patients rated their aesthetic outcome as \"excellent.\" No complications or secondary interventions occurred.</p><p><strong>Conclusions: </strong>Tragal cartilage contouring is an effective technique that can be performed during rhytidectomy. By addressing cartilage shape and tension distribution, this method preserves tragal contour and prevents common postoperative deformities, supporting consistently favorable aesthetic results.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147675684","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":"Long-Term Outcomes and Predictors of Postoperative Complications After Endoscopic Conjunctivodacryocystorhinostomy.","authors":"Maxim Bez, Etti Katzburg, Yanina Ivashko Pachima, Nadav Anteby, Muhammad Abumanhal, Avraham Abergel, Igal Leibovitch, Ran Ben Cnaan","doi":"10.1097/IOP.0000000000003213","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003213","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical outcomes of endoscopic conjunctivodacryocystorhinostomy with Jones tube placement and to identify patient- and surgery-related risk factors for postoperative complications.</p><p><strong>Methods: </strong>This single-center, retrospective case series analyzed 42 consecutive patients (42 eyes) who underwent endoscopic conjunctivodacryocystorhinostomy. Data were collected on patient demographics, comorbidities, and surgical variables, including Jones tube diameter (3.5 vs. 4.0 mm). Primary outcomes were anatomical and functional success. The primary endpoint for risk factor analysis was the occurrence of any postoperative complication. Univariate and multivariable logistic regression analyses were performed to identify significant predictors of adverse outcomes.</p><p><strong>Results: </strong>Over a mean follow-up of 4.6 years, the anatomical success rate was 83.3%, while the functional success rate was 66.7%. Tube displacement was a common complication, occurring in 23.8% of cases. In multivariable analysis, the use of a larger 4.0-mm tube was significantly protective against complications (adjusted odds ratio: 0.35, p = 0.007), whereas a diagnosis of preoperative dry eye disease significantly increased the risk (adjusted odds ratio: 1.71, p = 0.028). The benefit of the larger tube was primarily driven by a statistically significant reduction in the rate of tube displacement compared with the 3.5-mm tube (5.3% vs. 27.3%, p = 0.03).</p><p><strong>Conclusion: </strong>Larger-diameter (4.0 mm) Jones tube significantly reduces complications in endoscopic conjunctivodacryocystorhinostomy (particularly tube displacement), whereas preexisting dry eye symptoms were found to be associated with increased postoperative complications.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634032","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":"Glucagon-Like Peptide-1 Receptor Agonists and the Risk of Thyroid Eye Disease.","authors":"Jawad Muayad, Muhammad Z Chauhan, Leo M Hall, Akbar Shakoor, Ahmed B Sallam, Iqbal Ike K Ahmed, Amina I Malik, Robert C Kersten","doi":"10.1097/IOP.0000000000003222","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003222","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether glucagon-like peptide-1 receptor agonists (GLP-1RA) are associated with an altered risk of thyroid eye disease (TED) compared with other non-GLP-1RA glucose-lowering medications in patients with thyroid disease.</p><p><strong>Methods: </strong>This retrospective, population-based cohort study utilized the TriNetX U.S. Collaborative Network to identify patients with thyroid disease initiating a GLP-1RA or a non-GLP-1RA active control medication. After 1:1 propensity score matching, 2 balanced cohorts of 173,618 patients each were analyzed. Matching variables included demographics, comorbidities, hemoglobin A1c, body mass index, concomitant diabetes medications, radioactive iodine therapy, thyroid-specific laboratory values, and diabetes complication severity. Outcomes included TED-related diagnoses, surgical interventions, and systemic steroid use. Time-to-event analyses were performed using Cox proportional hazards models.</p><p><strong>Results: </strong>GLP-1RA use was associated with a significantly lower risk of TED compared with the active control group. The risk of a composite TED-related diagnosis was lower at 1 year (hazard ratio [HR] 0.82; 95% confidence interval [CI], 0.76-0.88), 2 years (HR 0.86; 95% CI, 0.81-0.91), and 3 years (HR 0.90; 95% CI, 0.86-0.95). Marked reductions were observed for TED-related surgical interventions (1-year HR 0.42, 95% CI 0.36-0.49; 3-year HR 0.54, 95% CI 0.48-0.61) and systemic steroid use. Subgroup analyses of patients with hyperthyroidism and individual agents demonstrated consistent protective associations.</p><p><strong>Conclusions: </strong>In a large, rigorously matched cohort, GLP-1RA therapy was associated with a reduced risk of TED diagnoses, surgeries, and systemic steroid use compared to other glucose-lowering medications. These findings suggest a potential protective role for GLP-1 signaling in modulating orbital inflammation, though prospective trials are required for confirmation.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634065","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":"Transorbital Approach to the Pterygopalatine Fossa Following Exenteration in Cadaveric Models.","authors":"Jessica Y Tong, Jeffrey Sung, Rowan Valentine, WengOnn Chan, Alkis J Psaltis, Dinesh Selva","doi":"10.1097/IOP.0000000000003224","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003224","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a transorbital approach to the pterygopalatine fossa following total exenteration.</p><p><strong>Methods: </strong>Cadaveric dissection study where 5 head specimens (10 orbits) were dissected. The technique involved (1) infraorbital nerve identification, (2) creation of a posterior osteotomy around the orbitomaxillary segment of the infraorbital nerve, and (3) removal of the posterior maxillary sinus wall. The pterygopalatine segment of V2 (pV2) and the third segment of the internal maxillary artery were visualized.</p><p><strong>Results: </strong>The orbital floor defect approximated a parallelogram, with its lateral, medial, anterior, and posterior borders measuring 13.2 mm × 13.5 mm × 7.9 mm × 8.3 mm, respectively. To access pV2, the posterior maxillary wall defect was 10.6 mm (height) × 11.4 mm (width), respectively. To access the internal maxillary artery, this bony defect increased to 17.1 mm (height) × 12.2 mm (width), respectively.</p><p><strong>Conclusions: </strong>Transorbital approaches to the pterygopalatine fossa following exenteration are feasible. Indications include orbital tumors with extension to the apex and pterygopalatine fossa, such as squamous cell carcinoma.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634082","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":"Orbital Cellular Myofibroma: A Rare Case With Detailed Vascular Characterization.","authors":"Sonia Anchouche, Kenneth Chang, Mohammad Altibi, Brendan C Dickson, Pascal J Mosimann, Dan D DeAngelis","doi":"10.1097/IOP.0000000000003199","DOIUrl":"https://doi.org/10.1097/IOP.0000000000003199","url":null,"abstract":"<p><p>This case report describes a rare presentation of orbital cellular myofibroma in a 30-year-old female who initially presented with right proptosis and conjunctival injection. Endovascular embolization followed by surgical resection revealed an unencapsulated, vascular tumor with histopathologic and molecular findings consistent with cellular myofibroma harboring an SRF::RELA gene fusion. This case highlights the diagnostic challenges associated with orbital tumors and the importance of considering myofibroma in the differential diagnosis. The report also underscores the role of multidisciplinary management in optimizing outcomes for patients with rare orbital neoplasms.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634044","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":"Safety Analysis of Oxymetazoline Eye Drops for Blepharoptosis Using the FDA Adverse Event Reporting System.","authors":"Daniel B Azzam, John D Hong, Teresa H Chen, Yosur G Alsulaiman, Seanna R Grob, Lilangi S Ediriwickrema, M Reza Vagefi, Jeremiah P Tao","doi":"10.1097/IOP.0000000000003226","DOIUrl":"10.1097/IOP.0000000000003226","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the safety of oxymetazoline hydrochloride ophthalmic solution 0.1% for blepharoptosis using real-world Food and Drug Administration Adverse Event Reporting System data.</p><p><strong>Methods: </strong>This retrospective pharmacovigilance study queried the Food and Drug Administration Adverse Event Reporting System database utilizing OpenVigil 2.1 for oxymetazoline eye drop adverse drug events (ADEs) from Food and Drug Administration approval on January 7, 2020, through April 30, 2025. Disproportionality analysis employed standard methodologies, including reporting odds ratios (RORs) and chi-squared analyses.</p><p><strong>Results: </strong>Three hundred six patients with 658 ADEs from oxymetazoline eye drop were analyzed, revealing 30 significant safety signals. All ADEs on the drug label were identified in this cohort (multiple RORs, all p < 0.001): ocular surface disease (N = 129, 34.5%), conjunctival hyperemia (N = 43, 11.5%), temporary visual blurring (N = 33, 8.8%), instillation site pain (N = 27, 7.2%), headache (N = 32, 8.6%). Novel ADEs (not on the drug label) were vitreoretinal complications (N = 12, 3.2%, multiple RORs, all p < 0.001)-retinal detachment (N = 3, 0.8%), vitreous detachment (N = 3, 0.8%), vitreous floaters (N = 3, 0.8%), and vitreous hemorrhage (N = 3, 0.8%)-mydriasis (N = 21, 5.6%, ROR 175.4 [112.4-273.7], p < 0.001), hypertension (N = 6, 1.6%, ROR 3.2 [1.4-7.2], p = 0.009), and tachyphylaxis (N = 5, 1.3%, ROR 5.1 [2.1-12.4], p < 0.001).</p><p><strong>Conclusions: </strong>This Food and Drug Administration Adverse Event Reporting System analysis of oxymetazoline eye drops corroborated prior ADEs, including ocular surface disease, conjunctival hyperemia, transient blurred vision, instillation site pain, and headache. The study revealed new safety signals for vitreoretinal complications, hypertension, mydriasis, and tachyphylaxis. Further studies are warranted to confirm these associations and describe mechanisms such as vitreoretinal traction.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634034","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}