Ophthalmic Plastic and Reconstructive Surgery最新文献

{"title":"Double Lacrimal Puncta in a Case of Coffin-Siris Syndrome.","authors":"Vivek Singh, Md Shahid Alam","doi":"10.1097/IOP.0000000000003200","DOIUrl":"10.1097/IOP.0000000000003200","url":null,"abstract":"","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e251"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227520","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":"Eyelid Xanthelasma and Cardiovascular Outcomes: A Propensity-Matched Analysis.","authors":"Niloufar Bineshfar, Gabriella Schmuter, Jaffer Shah, Kyle J Godfrey, Wendy W Lee","doi":"10.1097/IOP.0000000000003187","DOIUrl":"10.1097/IOP.0000000000003187","url":null,"abstract":"<p><strong>Purpose: </strong>Xanthelasma palpebrarum (XP) is a common periocular lesion often regarded as benign. However, its potential association with systemic lipid dysregulation and cardiovascular disease remains controversial. This study aimed to evaluate the relationship between XP, dyslipidemia, and major cardiovascular outcomes using a large-scale, electronic health record dataset.</p><p><strong>Methods: </strong>This retrospective propensity score-matched cohort study used de-identified electronic health record data from TriNetX, a global federated research network. Adults aged 20 to 85 years with and without XP were identified between August 5, 2005, and August 5, 2025. XP cases were matched 1:1 to controls without XP based on age, sex, comorbidities, and other covariates. Primary outcomes included the incidence of hyperlipidemia and major adverse cardiovascular events. Secondary measures included lipid profile values and use of lipid-lowering medications. Cox proportional hazards models estimated hazard ratios (HRs) for outcomes, adjusted for demographics and comorbidities.</p><p><strong>Results: </strong>A total of 40,096 patients (20,048 with XP; 20,048 controls) were included in the analysis. The mean age at index was 53.7 years in both groups. Male sex accounted for 28.3% of the XP cohort and 28.4% of the control group. Lipid profiles differed significantly between groups. Compared with controls, patients with XP had higher rates of hyperlipidemia (32.2% vs. 27.6%; p < 0.0001) and major adverse cardiovascular event (13.0% vs. 11.4%; p < 0.0001), while all-cause mortality was not significantly different in unadjusted comparisons (3.1% vs. 3.3%; p = 0.27). In Cox proportional hazards models, XP was associated with increased risk of hyperlipidemia (HR: 1.38; 95% CI: 1.35-1.41; p < 0.0001), major adverse cardiovascular event (HR: 1.26; 95% CI: 1.22-1.31; p < 0.0001), and a statistically significant but small elevation in all-cause mortality (HR: 1.09; 95% CI: 1.01-1.17; p = 0.0324).</p><p><strong>Conclusions: </strong>XP is significantly associated with atherogenic lipid profiles, greater use of lipid-lowering medications, and increased risk of cardiovascular events. Recognition of XP during routine ophthalmic examinations may provide an opportunity for early cardiovascular risk stratification.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"543-547"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195227","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":"Dacryocystorhinostomy Practice Patterns Among ASOPRS Members: A Shift in Preferences and Attitudes.","authors":"Giorgio Sanchez Figueroa, Nicole Sanchez Figueroa, Alaa Abdelsalam, Caroline Y Yu, Elizabeth A Bradley, Andrea A Tooley, Gregory J Griepentrog, Lilly H Wagner","doi":"10.1097/IOP.0000000000003188","DOIUrl":"10.1097/IOP.0000000000003188","url":null,"abstract":"<p><strong>Purpose: </strong>To determine current dacryocystorhinostomy (DCR) practice patterns of American Society of Ophthalmic Plastic and Reconstructive Surgery members and identify surgeon and case-related factors impacting preference for endoscopic versus external DCR and the use of preoperative imaging.</p><p><strong>Methods: </strong>A cross-sectional web-based anonymous 16-question survey was distributed to 277 American Society of Ophthalmic Plastic and Reconstructive Surgery members enrolled in survey-based research. The survey assessed surgeons' demographics, practice settings, surgical preferences, and imaging practices. Responses were summarized and compared using statistical tests for frequency distribution.</p><p><strong>Results: </strong>A total of 111 surgeons (40.0%) responded to the survey. Utilization of endoscopic DCR (endoDCR) was highly variable, with 57% of junior surgeons (<5 years in practice) using it for >66% of their cases, compared with only 18.3% of surgeons with >15 years postfellowship experience. High utilization of endoDCR (>66% of cases) was more common in academic surgeons compared with private practice (48.4% vs. 19.6%, p < 0.01). The most cited reasons for endoDCR were scar avoidance and revision surgery. For external DCR, anatomical barriers and concern for mass/need for biopsy were common indications. Most surgeons only order imaging for certain indications, such as prior sinonasal surgery, facial trauma, suspected tumor, or atypical presentation.</p><p><strong>Conclusion: </strong>Utilization of endoDCR was correlated with years in practice, with younger surgeons preferring the endoscopic technique. A large majority felt that the relevance of imaging is low in most patients. Future research is needed to standardize case-based indications for endoscopic versus external approaches and preoperative imaging.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"548-553"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195298","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":"Reticular Fiber Distribution in the Upper Eyelid of East Asians.","authors":"Hirohiko Kakizaki, HeeBae Ahn, Derrick Lian, Kan Ishijima, Yoshio Ikeda","doi":"10.1097/IOP.0000000000003182","DOIUrl":"10.1097/IOP.0000000000003182","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the distribution of reticular fibers in the upper eyelid of East Asians.</p><p><strong>Methods: </strong>Central sagittal sections of 24 upper eyelids were obtained from 15 East Asian cadavers aged 36 to 94 years. The specimens were fixed in 10% formalin and stained with silver nitrate.</p><p><strong>Results: </strong>Reticular fibers were abundantly distributed in the upper eyelids. Sheet-like reticular fibers were observed beneath the skin and conjunctiva. The hard tissue of the eyelid margin and the tarsal plate had a lot of reticular fibers. The areas of the tarsal plate without Meibomian glands also demonstrated abundant reticular fibers. The glands (Moll, Zeis, Meibomian, Krause, Wolfring, eccrine, and sebaceous), orbicularis oculi muscle fibers, levator muscle fibers, Müller muscle fibers, cilia, arteries, nerves, and muscle spindles were all surrounded by reticular fibers of comparatively high density. The levator aponeurosis, orbital septum, Whitnall's ligament, and intermuscular transverse ligament showed diffuse distributions of reticular fibers. In contrast, the subcutaneous connective tissue and adipose tissue demonstrated sparse or coarse distributions of reticular fibers. In elderly specimens, both intact and degenerated reticular fibers were observed. A lacerated orbital septum contained few reticular fibers.</p><p><strong>Conclusion: </strong>Reticular fibers were distributed a lot in the upper eyelids of East Asians, adapting flexibly to the characteristics of each structure. Elderly specimens exhibited degenerated reticular fibers.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"601-608"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195309","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":"Extended Long-Term Follow-Up of Proptosis Regression After Teprotumumab Treatment for Thyroid Eye Disease.","authors":"Tatiana R Rosenblatt, Carolina A Chiou, Michael K Yoon, Nahyoung Grace Lee, Natalie Wolkow, Suzanne K Freitag","doi":"10.1097/IOP.0000000000003197","DOIUrl":"10.1097/IOP.0000000000003197","url":null,"abstract":"<p><strong>Purpose: </strong>A previous study found high rates of proptosis regression after teprotumumab treatment for thyroid eye disease, though having been published relatively early in the teprotumumab era, it had gaps in follow-up frequency and duration. This study extends on the previously reported cohort to better understand teprotumumab's durability.</p><p><strong>Methods: </strong>Retrospective analysis of all patients who completed all 8 teprotumumab infusions at 1 institution from January 1, 2020 to December 31, 2022. Primary outcomes were proptosis regression at most recent follow-up compared with immediately posttreatment and pretreatment.</p><p><strong>Results: </strong>Of 113 patients, 150 (66.4%) eyes of 83 patients had regression at most recent follow-up (mean 20.4 months posttreatment) compared with immediately posttreatment, averaging 2.8 mm (range 0.5-10.0). Ninety-five eyes of 55 patients (42.0%) regressed by ≥2 mm (mean 3.8, range 2.0-10.0). Mean time to first documentation of regression was 10.2 months (range 2.7-39.0); 67.2% of eyes continued to worsen after initial regression. Compared with pretreatment, 137 eyes of 77 patients (60.6%) had net improvement, averaging 2.7 mm (range 0.5-10.0), while 71 eyes of 43 patients (31.4%) regressed to become worse than pretreatment by 1.8 mm (range 0.5-5.0). Thyroid eye disease flare occurred in 61 (54.0%) patients, defined as a clinical activity score increase ≥2 (n = 6, 5.3%), proptosis regression ≥2 mm (n = 37, 32.7%), or both (n = 18, 15.9%).</p><p><strong>Conclusions: </strong>This extended follow-up analysis demonstrated proptosis regression after teprotumumab in two-thirds of eyes at long-term follow-up, with one-third worsening beyond pretreatment proptosis. Two-thirds continued to worsen after initial regression, and over half of patients developed a thyroid eye disease flare. Though most patients maintained net improvement, these results suggest that proptosis effects are not durable in most patients after standard teprotumumab dosing.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"564-569"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202340","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 Waldenström Macroglobulinemia With Angiopathic Paraprotein Deposition: A Case Report.","authors":"Terence Ang, Abdullah Almater, Craig James, Dinesh Selva","doi":"10.1097/IOP.0000000000003160","DOIUrl":"10.1097/IOP.0000000000003160","url":null,"abstract":"<p><p>Ocular manifestations of Waldenström macroglobulinemia (WM) are most frequently related to hyperviscosity-related retinopathy but may also include conjunctival infiltration and vitritis. Orbital and ocular adnexal lymphomatous deposition, including within the orbit, is exceedingly rare. We report a unique case of a 66-year-old female with orbital infiltration from WM presenting with recurrent episodes of transient vision loss secondary to angiopathic deposition of eosinophilic hyaline paraprotein in the absence of hyperviscosity syndrome. Right orbital biopsy demonstrated adipose tissue with deposition of eosinophilic hyaline material, outlining adipocytes and deposited within walls of blood vessels. The material was strongly PAS positive, weakly metachromatic with crystal violet but was negative for apple-green birefringence on Congo red staining. IgM immunohistochemistry strongly decorated the orbital eosinophilic material, suggesting macroglobulinosis paraprotein deposition and not amyloid. There was an associated patchy infiltrate of low-grade lymphoplasmacytic B-cell lymphoma with kappa light chain restriction demonstrated in the neoplastic plasma cell population, consistent with her known WM.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e213-e215"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794487","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":"Locally Advanced Conjunctival Squamous Cell Carcinoma not Responsive to Immune Checkpoint Inhibitor Therapy: 3 Cases and a Literature Review.","authors":"Natalie Wolkow, Nahyoung G Lee, Kevin S Emerick, Suzanne K Freitag, Howard L Kaufman, David M Miller, Han-Ying P Chang, Anna M Stagner","doi":"10.1097/IOP.0000000000003174","DOIUrl":"10.1097/IOP.0000000000003174","url":null,"abstract":"<p><p>Three patients with locally advanced conjunctival squamous cell carcinoma originating in the inferior fornix were treated with immunotherapy: a 74-year-old male was treated with 4 cycles of cemiplimab, a 54-year-old female was treated with 3 cycles of pembrolizumab, and a 69-year-old female was treated with 2 cycles of pembrolizumab. Tumor progressed in all 3 patients on immunotherapy, requiring orbital exenteration for disease control. Tumor mutational burden was low in all 3 patients: 1.2, 8.1, and 7.1 mut/Mb. Review of the literature reveals 18 cases of invasive conjunctival squamous cell carcinoma treated with immunotherapy in addition to the 3 cases reported herein, with tumors of responders tending to have a higher tumor mutational burden than those of nonresponders. There is increasing evidence that conjunctival squamous cell carcinoma originating in the sun-protected inferior fornix/inferior palpebral conjunctiva has low tumor mutational burden and is less likely to respond to immunotherapy than squamous cell carcinoma of bulbar conjunctival origin.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"e231-e237"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966575","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":"Combined Endoscopic and External Dacryocystectomy Surgical Approach for Rare Tumors of the Lacrimal Sac.","authors":"Nicholas Tomaras, Sasha Hubschman, Marianna Vakaki, Agnes Park, Victoria S Lee, Ann Q Tran","doi":"10.1097/IOP.0000000000003261","DOIUrl":"10.1097/IOP.0000000000003261","url":null,"abstract":"<p><p>Lacrimal sac epithelial tumors are rare and often present with subtle symptoms. We report 2 cases managed with combined external dacryocystectomy and endoscopic endonasal resection. Case 1 involved a 59-year-old female with lacrimal sac inverted papilloma extending into the nasolacrimal duct and inferior meatus. Case 2 involved a 79-year-old male with a chronically draining medial canthal wound and progressive induration after prior cyst excision, ultimately diagnosed as lacrimal sac oncocytoma. In both cases, preoperative imaging and clinical features demonstrated nasolacrimal duct involvement and adjacent anatomic distortion, prompting combined surgery for direct visualization and controlled resection of the lacrimal sac and ductal components. The combined approach allowed safe excision despite ductal expansion and adjacent tissue involvement. A small localized recurrence in case 1 at 11 months was successfully managed with in-office resection. These cases support case-selected multidisciplinary external-endonasal surgery for lacrimal sac tumors with nasolacrimal duct involvement.</p>","PeriodicalId":19588,"journal":{"name":"Ophthalmic Plastic and Reconstructive Surgery","volume":" ","pages":"595-600"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536383","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":"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":"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":"588-594"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","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":"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":"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":"582-587"},"PeriodicalIF":1.6,"publicationDate":"2026-09-01","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}