Orthopedics最新文献

{"title":"Evaluating the References of Insurance Policies for Computer-Assisted Navigation in Total Knee Arthroplasty Compared With the American Academy of Orthopaedic Surgeons Clinical Practice Guideline.","authors":"Eric H Lin, Jacob L Kotlier, Amir Fathi, Cailan L Feingold, Nathanael D Heckmann, Joseph N Liu, Frank A Petrigliano","doi":"10.3928/01477447-20241104-03","DOIUrl":"https://doi.org/10.3928/01477447-20241104-03","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the quality and quantity of sources cited by insurance payers for computer-assisted navigation (CAN) in total knee arthroplasty (TKA) and to compare these sources with those cited by the American Academy of Orthopaedic Surgeons (AAOS) Clinical Practice Guideline (CPG).</p><p><strong>Materials and methods: </strong>References were included from insurance payer policies on CAN that discussed the use of CAN in TKA, while every reference from the AAOS CPG for surgical navigation in TKA was included.</p><p><strong>Results: </strong>Fifty-four unique articles from insurance payers met criteria, with 68.5% being primary journal articles and 18.5% being reviews. The quality of cited studies was relatively evenly distributed between level of evidence (LOE) I/II (42.6%) and LOE III and below (50.0%). The 14 references cited in the AAOS CPG were 100% primary articles and 100% LOE I/II. Only 16.3% of cited insurance references were AAOS CPG articles. Nine of the 14 AAOS CPG studies were not cited by any of the insurance payer policies.</p><p><strong>Conclusion: </strong>Compared with the AAOS CPG, insurance policies cited older articles with lower LOE. We recommend continued updating of the AAOS CPG and insurance policies as more research into the use of CAN in TKA is published. [<i>Orthopedics</i>. 202x;4x(x):xx-xx.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"1-4"},"PeriodicalIF":1.1,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604306","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":"Assessing the Accuracy and Reliability of the Fluoroscopic Ruler for Comminuted Femur Fractures: A Cadaveric Study.","authors":"Brian D Wahlig, Nicolas P Kuttner, Frank A Kouzel-Martinez, Samuel E Broida, Stephen A Sems, Krystin A Hidden, Brandon J Yuan","doi":"10.3928/01477447-20240918-03","DOIUrl":"10.3928/01477447-20240918-03","url":null,"abstract":"<p><strong>Background: </strong>Fixation of comminuted femur fractures may result in limb length discrepancy. Intraoperative fluoroscopic measurement of the contralateral femur with a ruler is commonly performed to establish a reference for femoral length. No evidence regarding the reliability and accuracy of this technique exists. This study aimed to assess the accuracy and interrater reliability of a fluoroscopic ruler in obtaining correct femoral length in a comminuted femoral shaft fracture model.</p><p><strong>Materials and methods: </strong>Approximately 5 cm of bone was removed from the left femoral diaphyses of 8 cadavers. Seven orthopedic surgery residents and 2 attendings measured the length of the intact contralateral femur using a ruler under fluoroscopy. The ruler was then applied to the \"fractured\" femur with manual traction applied until femoral length matched the measured length of the contralateral femur. The resulting gap in the \"fractured\" femur was compared with the length of bone that had been resected. Data were analyzed using means, SDs, and intraclass correlation coefficients (ICCs).</p><p><strong>Results: </strong>Fifty-seven measurements were collected. The mean difference between the measured fracture gap and the length of bone removed was 8.0±5.8 mm (range, 0-22 mm). Femoral length was accurate to 5 mm in 40% of cases, 10 mm in 70%, 15 mm in 81%, 20 mm in 98%, and 25 mm in 100%. The overall interrater reliability was poor (ICC, 0.11; 95% CI, 0.001-0.44).</p><p><strong>Conclusion: </strong>Despite poor interrater reliability, the fluoroscopic ruler resulted in a mean leg length discrepancy of 8.0±5.8 mm in this cadaveric study. [<i>Orthopedics</i>. 2024;47(6):327-331.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"327-331"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308259","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 Mental Health Disorders Affect Opioid Consumption and Perioperative Complications After Total Shoulder Arthroplasty.","authors":"Cory K Mayfield, Maya S Abu-Zahra, Ioanna K Bolia, Jacob L Kotlier, Eric H Lin, Seth C Gamradt, Alexander E Weber, Joseph N Liu, Frank A Petrigliano","doi":"10.3928/01477447-20240918-01","DOIUrl":"10.3928/01477447-20240918-01","url":null,"abstract":"<p><strong>Background: </strong>Limited evidence exists regarding the influence of mental health disorders (MHDs) on opioid use and complications after total shoulder arthroplasty (TSA). We aimed to identify the prevalence of common MHDs among patients undergoing anatomic TSA (aTSA) and reverse TSA (rTSA).</p><p><strong>Materials and methods: </strong>The Premier Healthcare Database was queried for patients undergoing primary aTSA and rTSA from 2016 to 2020. <i>International Classification of Diseases, Tenth Revision,</i> diagnosis codes were used to identify MHDs. Primary outcomes included the prevalence of MHDs, perioperative opioid consumption, and 90-day risk of postoperative complications, revision, and readmission. Bivariate and multivariate regression analyses were performed to assess 90-day risk of primary endpoints while controlling for potential confounders. Statistical significance was defined as <i>P</i><.05.</p><p><strong>Results: </strong>From 2016 to 2020, 49,997 of 144,725 (34.55%) patients undergoing primary TSA had at least one diagnosed MHD. The most prevalent were depression (17.03%), anxiety (16.75%), and substance use disorder (10.20%). Patients with a MHD had higher mean hospital costs ($75,984±$43,129 vs $73,316±$39,046, <i>P</i><.0001), longer mean length of stay (1.95±2.25 days vs 1.61±1.51 days, <i>P</i><.0001), and higher mean total postoperative opioid use (72.00±231.55 morphine milligram equivalents [MMEs] vs 59.32±127.31 MMEs, <i>P</i><.0001). Periprosthetic fractures (odds ratio, 1.20; <i>P</i>=.041), dislocation (odds ratio, 1.12; <i>P</i>=.042), and 90-day readmission rates (odds ratio, 1.26; <i>P</i><.001) were significantly higher among patients with a MHD.</p><p><strong>Conclusion: </strong>This study found that MHDs are associated with significantly increased perioperative opioid consumption, medical and surgical complication rates, and risk of readmission after TSA. Recognition and optimization of MHDs is critical to minimizing complications and opioid consumption after TSA. [<i>Orthopedics</i>. 2024;47(6):e303-e310.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e303-e310"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308261","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 Use of Telehealth to Improve Office Efficiency and Health Care Access Among Patients Being Evaluated for Revision Total Joint Arthroplasty.","authors":"Rex W Lutz, Tia N Alexander, Joseph A S McCahon, Adam J Lencer, Harrison A Patrizio, P Maxwell Courtney, Gregory K Deirmengian","doi":"10.3928/01477447-20240826-02","DOIUrl":"10.3928/01477447-20240826-02","url":null,"abstract":"<p><strong>Background: </strong>Patients being evaluated for revision total joint arthroplasty (RTJA) are often referred to tertiary care centers, which may decrease their access to adequate health care and overburden these health care systems. The purpose of this study was to evaluate the feasibility and effectiveness of RTJA patient evaluation via telehealth.</p><p><strong>Materials and methods: </strong>We identified a consecutive series of patients newly evaluated for a symptomatic TJA by two academic surgeons during a 1-year period. Clinical records, radiographs, and laboratory values were reviewed to determine whether the patient was indicated for RTJA. Efficiency was determined by calculating the percentage of patients who could have been adequately evaluated with telehealth. We then used the modalities required for diagnosis in each RTJA case to determine the feasibility of evaluating such patients through telehealth.</p><p><strong>Results: </strong>Of the 381 patients evaluated for RTJA candidacy, 154 (40.4%) were indicated for revision surgery. All 152 patients evaluated for possible hip revision could have been evaluated and diagnosed via telehealth, demonstrating a telehealth efficiency of 100%. Of 229 patients evaluated for possible knee revision, 183 were able to be evaluated and diagnosed via telehealth. The 46 remaining patients were indicated for revision secondary to instability, which would require an in-office examination for diagnosis. The efficiency of telehealth for potential knee revision patients was 79.9%.</p><p><strong>Conclusion: </strong>Telehealth may be useful in evaluating patients with symptomatic TJA. It may increase the efficiency of in-office evaluations and reduce potential barriers to health care access. [<i>Orthopedics</i>. 2024;47(6):372-376.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"372-376"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110503","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":"Biologic Augmentation of Rotator Cuff Repair: Current Concepts Review.","authors":"Colin L Uyeki, Brian T Ford, Matthew E Shuman, Benjamin C Hawthorne, Ian J Wellington, Augustus D Mazzocca","doi":"10.3928/01477447-20241028-01","DOIUrl":"10.3928/01477447-20241028-01","url":null,"abstract":"<p><p>Rotator cuff tears are common in an aging population. Thus far, primary repairs have shown high re-tear rates suggesting the need for improved healing modalities. Current augmentations of rotator cuff repairs include synthetic and biological scaffolds, surgical bone marrow venting, and infusing the repair with a variety of stem cells and growth factors aimed at restoring the native cellular structure and function of the repaired tissue. This current concepts review discusses the anatomy, physical presentation, diagnosis, and treatment of rotator cuff tears; biological adjuvants for rotator cuff repairs; and the current literature on outcomes after biologically augmented rotator cuff repairs. [<i>Orthopedics</i>. 2024;47(6):e282-e286.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e282-e286"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568624","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":"Disparities Exist in Knowledge of Hip Fracture Compared With Stroke and Myocardial Infarction.","authors":"Sara Choy, Thompson Zhuang, Lauren Shapiro, Robin Kamal","doi":"10.3928/01477447-20240826-05","DOIUrl":"10.3928/01477447-20240826-05","url":null,"abstract":"<p><strong>Background: </strong>This study sought to answer the following questions: (1) Are there differences in knowledge on time to treatment (TTT) between stroke, myocardial infarction (MI), and hip fractures in the general population? (2) Are there differences in condition-specific knowledge across these conditions? (3) Are there underlying demographic factors that may contribute to differences in hip fracture-specific knowledge?</p><p><strong>Materials and methods: </strong>This was a cross-sectional cohort analysis. Participants were acquired using an online survey distribution platform, Amazon Mechanical Turk (MTurk). Individuals older than 18 years with English fluency and literacy were included. A total of 913 participants who completed a survey with questions on TTT knowledge, condition-specific knowledge, history of hip fracture, and demographics were recruited.</p><p><strong>Results: </strong>On comparing TTT knowledge, the MI mean score was 36.92% higher than that of hip fractures (<i>P</i><.0001). On comparing condition-specific knowledge, the MI-specific mean score was 8.24% higher than that of hip fractures (<i>P</i><.0001). Hip fracture knowledge was associated with demographic factors. Asian and Black participants and participants with Medicaid or Medicare as their primary insurance type were associated with significantly lower hip fracture knowledge.</p><p><strong>Conclusion: </strong>Hip fracture knowledge was significantly lower than MI knowledge in the study population. Just as professional societies have invested resources in public education campaigns on the importance of TTT for stroke and MI, public education campaigns on the importance of TTT for hip fractures may support earlier TTT for populations vulnerable to delays (Asian and Black). [<i>Orthopedics.</i> 2024;47(6):377-383.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"377-383"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110497","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":"Bizarre Parosteal Osteochondromatous Proliferation With Malignant Transformation and Metastases.","authors":"Gary Ulrich, Robert Wood, Jacob Pearson, Max Jiganti, Nicholas Tedesco","doi":"10.3928/01477447-20241016-01","DOIUrl":"10.3928/01477447-20241016-01","url":null,"abstract":"<p><p>A patient with a benign bizarre parosteal osteochondromatous proliferation (BPOP) located in the anterior knee was treated with resection in preparation for total knee arthroplasty (TKA). The BPOP reoccurred and was treated with re-resection at the time of TKA. The BPOP reoccurred a second time and underwent malignant transformation to a fungating high-grade pleomorphic sarcoma with metastatic lesions. This case highlights the rare potential of a previously benign BPOP to undergo malignant transformation after recurrence. A wide margin resection may be considered primarily when surgery is indicated to prevent recurrence and its potential sequelae. [<i>Orthopedics</i>. 2024;47(6):e322-e326.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e322-e326"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471751","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":"Bibliometric Analysis of Predictors of Altmetric Attention Scores in Orthopedic Research: Investigating Online Visibility.","authors":"Muhammad Talal Ibrahim, Hamza Imran, Muhammad Hamza Shuja, Haider Sheraz, Andrew Howard, Shahryar Noordin","doi":"10.3928/01477447-20240809-03","DOIUrl":"10.3928/01477447-20240809-03","url":null,"abstract":"<p><strong>Background: </strong>Altmetric Attention Score (AAS) captures online attention received by a research article in addition to traditional bibliometrics. We present a comprehensive bibliometric analysis of high AAS articles and identify predictors of AAS in orthopedics.</p><p><strong>Materials and methods: </strong>The top 30 articles with highest AAS were selected from orthopedic journals using the Dimensions App. Multilevel mixed-effects linear regression was used to address clustering in articles from the same journal, with journals as the leveling variable.</p><p><strong>Results: </strong>A total of 750 articles from 25 journals were included. In the final multivariable model, the funding source (none, industry, government, foundation, university, or multiple), findings (positive, negative, neutral, or not applicable), and the journal's impact factor were significant at <i>P</i><.05.</p><p><strong>Conclusion: </strong>Predictors of AAS are similar to predictors of traditional bibliometrics. Future studies need prospective dynamic data to further elucidate the AAS. [<i>Orthopedics</i>. 2024;47(6):e317-e321.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e317-e321"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009108","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":"Surgeons Who Perform Total Hip Arthroplasty Are at Risk for Noise-Induced Hearing Loss, Especially When Using Automated Broaching.","authors":"Rex W Lutz, Danielle Ponzio, Stephanie A Kwan, Hope S Thalody, Quincy Cheesman, Harrison A Patrizio, Alvin C Ong, Gregory K Deirmengian","doi":"10.3928/01477447-20240809-06","DOIUrl":"10.3928/01477447-20240809-06","url":null,"abstract":"<p><strong>Background: </strong>Noise-induced hearing loss (NIHL) is a serious concern for orthopedic surgeons. The National Institute for Occupational Safety and Health (NIOSH) sets the safe exposure limit at 85 dB for 8 hours, yet operating rooms often surpass this limit. This study investigated if using an automated broaching system exposes orthopedic surgeons to dangerous decibel (dB) levels.</p><p><strong>Materials and methods: </strong>A prospective study analyzed 138 intraoperative sound recordings from 92 total hip arthroplasty (THA) surgeries and 46 baseline measurements at an academic-affiliated private practice, using the NIOSH Sound Level Meter (SLM) application and a microphone. The surgeries were categorized into manual and automated broaching. Key metrics measured included maximal dB level (MDL), peak sound pressure (LC_peak), average continuous sound (LA_eq), and average weighted sound in an 8-hour period (TWA), along with dose representations, to identify hazardous noise levels.</p><p><strong>Results: </strong>Of the 92 THA sound recordings, 50 used manual broaching and 42 employed automated broaching. Automated broaching exhibited higher noise levels, with an average MDL of 109.92 dBA, a LA_eq of 86.09 dBA, a TWA of 76.48 dBA, and a projected noise dose of 137.74%. In contrast, manual broaching exhibited an average MDL of 105.87 dBA, a LA_eq of 83.06 dBA, a TWA of 72.82 dBA, and a projected noise dose of 82.02%.</p><p><strong>Conclusion: </strong>This study highlights the auditory risks from automated broach and manual THA surgeries that orthopedic surgeons experience. Manufacturers should focus on reducing instrument noise when designing surgical tools and orthopedic surgeons and operating room staff should take measures to protect themselves from NIHL during surgery. [<i>Orthopedics</i>. 2024;47(6):349-354.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"349-354"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009113","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":"Incidence of Parental Requests to Discontinue Growth-Friendly Surgical Lengthening for Early Onset Scoliosis.","authors":"Emily Robertson, Robert F Murphy, Jason B Anari, John B Emans, Paul D Sponseller, Amer F Samdani, John T Smith, William R Barfield, James F Mooney","doi":"10.3928/01477447-20240826-07","DOIUrl":"10.3928/01477447-20240826-07","url":null,"abstract":"<p><strong>Background: </strong>The STOP questionnaire was developed to document reasons for discontinuation of growth-friendly (GF) treatment in early onset scoliosis (EOS). This study investigated the incidence of parental request (PR) on the STOP questionnaire and compared clinical information and Early Onset Scoliosis 24-Item Questionnaire (EOSQ-24) scores of PR patients with those whose parents did not request discontinuation (non-parent request [NPR]).</p><p><strong>Materials and methods: </strong>An international pediatric spine registry was queried for EOS patients with STOP questionnaires completed by their surgeon. Age at discontinuation, sex, and EOS etiology were recorded. GF device, number of surgical procedures, complications, STOP questionnaire reasons for discontinuation, and definitive treatment were recorded. EOSQ-24 scores and clinical information in the PR cohort were compared with the NPR cohort.</p><p><strong>Results: </strong>Data for 1326 patients were analyzed. PR was listed on the STOP questionnaires of 46 (3.5%) patients, completed at a mean age of 12 years (SD, 3.2 years). There were no statistical differences in number of procedures or complications when comparing the PR cohort with the NPR cohort. PR patients more frequently had neuromuscular EOS (<i>P</i>=.002), more frequently were treated with magnetically controlled growing rods (33% vs 14%, <i>P</i>=.036), and more frequently were observed after GF discontinuation (<i>P</i>=.628). EOSQ-24 scores for the PR cohort were significantly lower in most domains except pain/discomfort.</p><p><strong>Conclusion: </strong>For 3.5% of the EOS patients, PR was listed on the STOP questionnaire. They frequently had neuromuscular EOS and frequently were treated with magnetically controlled growing rods. Additionally, these patients had statistically lower EOSQ-24 scores across most domains. [<i>Orthopedics</i>. 2024;47(6):e311-e316.].</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e311-e316"},"PeriodicalIF":1.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110499","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}