Periodontology 2000Pub Date : 2024-02-01Epub Date: 2023-10-30DOI: 10.1111/prd.12532
Angel Insua, Pablo Galindo-Moreno, Richard J Miron, Hom-Lay Wang, Alberto Monje
{"title":"Emerging factors affecting peri-implant bone metabolism.","authors":"Angel Insua, Pablo Galindo-Moreno, Richard J Miron, Hom-Lay Wang, Alberto Monje","doi":"10.1111/prd.12532","DOIUrl":"10.1111/prd.12532","url":null,"abstract":"<p><p>Implant dentistry has evolved to the point that standard implant osseointegration is predictable. This is attributed in part to the advancements in material sciences that have led toward improvements in implant surface technology and characteristics. Nonetheless, there remain several cases where implant therapy fails (specifically at early time points), most commonly attributed to factors affecting bone metabolism. Among these patients, smokers are known to have impaired bone metabolism and thus be subject to higher risks of early implant failure and/or late complications related to the stability of the peri-implant bone and mucosal tissues. Notably, however, emerging data have unveiled other critical factors affecting osseointegration, namely, those related to the metabolism of bone tissues. The aim of this review is to shed light on the effects of implant-related factors, like implant surface or titanium particle release; surgical-related factors, like osseodensification or implanted biomaterials; various drugs, like selective serotonin reuptake inhibitors, proton pump inhibitors, anti-hypertensives, nonsteroidal anti-inflammatory medication, and statins, and host-related factors, like smoking, diet, and metabolic syndrome on bone metabolism, and aseptic peri-implant bone loss. Despite the infectious nature of peri-implant biological complications, these factors must be surveyed for the effective prevention and management of peri-implantitis.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"27-78"},"PeriodicalIF":18.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71413401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Periodontology 2000Pub Date : 2024-02-01Epub Date: 2023-06-05DOI: 10.1111/prd.12489
Sukirth M Ganesan, Tabitha K Peter, Miyuraj H H Withanage, Frank Boksa, Erliang Zeng, April Martinez, Shareef M Dabdoub, Kunaal Dhingra, Yvonne Hernandez-Kapila
{"title":"COVID-19 associated oral and oropharyngeal microbiome: Systematic review and meta-analysis.","authors":"Sukirth M Ganesan, Tabitha K Peter, Miyuraj H H Withanage, Frank Boksa, Erliang Zeng, April Martinez, Shareef M Dabdoub, Kunaal Dhingra, Yvonne Hernandez-Kapila","doi":"10.1111/prd.12489","DOIUrl":"10.1111/prd.12489","url":null,"abstract":"<p><p>Three years into the coronavirus disease 2019 (COVID-19) pandemic, there are still growing concerns with the emergence of different variants, unknown long- and short-term effects of the virus, and potential biological mechanisms underlying etiopathogenesis and increased risk for morbidity and mortality. The role of the microbiome in human physiology and the initiation and progression of several oral and systemic diseases have been actively studied in the past decade. With the proof of viral transmission, carriage, and a potential role in etiopathogenesis, saliva and the oral environment have been a focus of COVID-19 research beyond diagnostic purposes. The oral environment hosts diverse microbial communities and contributes to human oral and systemic health. Several investigations have identified disruptions in the oral microbiome in COVID-19 patients. However, all these studies are cross-sectional in nature and present heterogeneity in study design, techniques, and analysis. Therefore, in this undertaking, we (a) systematically reviewed the current literature associating COVID-19 with changes in the microbiome; (b) performed a re-analysis of publicly available data as a means to standardize the analysis, and (c) reported alterations in the microbial characteristics in COVID-19 patients compared to negative controls. Overall, we identified that COVID-19 is associated with oral microbial dysbiosis with significant reduction in diversity. However, alterations in specific bacterial members differed across the study. Re-analysis from our pipeline shed light on Neisseria as the potential key microbial member associated with COVID-19.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"603-626"},"PeriodicalIF":17.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10026499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Periodontology 2000Pub Date : 2024-02-01Epub Date: 2023-09-22DOI: 10.1111/prd.12520
Richard J Miron, Yufeng Zhang
{"title":"Understanding exosomes: Part 1-Characterization, quantification and isolation techniques.","authors":"Richard J Miron, Yufeng Zhang","doi":"10.1111/prd.12520","DOIUrl":"10.1111/prd.12520","url":null,"abstract":"<p><p>Exosomes are the smallest subset of extracellular signaling vesicles secreted by most cells with a diameter in the range of 30-150 nm. Their use has gained great momentum recently due to their ability to be utilized as diagnostic tools with a vast array of therapeutic applications. Over 5000 publications are currently being published yearly on this topic, and this number is only expected to dramatically increase as novel therapeutic strategies continue to be investigated. This review article first focuses on understanding exosomes, including their cellular origin, biogenesis, function, and characterization. Thereafter, overviews of the quantification methods and isolation techniques are given with discussion over their potential use as novel therapeutics in regenerative medicine.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"231-256"},"PeriodicalIF":18.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41143054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Periodontology 2000Pub Date : 2024-02-01Epub Date: 2023-09-08DOI: 10.1111/prd.12522
Maria Elisa Galarraga-Vinueza, Shayan Barootchi, Marc L Nevins, Myron Nevins, Richard J Miron, Lorenzo Tavelli
{"title":"Twenty-five years of recombinant human growth factors rhPDGF-BB and rhBMP-2 in oral hard and soft tissue regeneration.","authors":"Maria Elisa Galarraga-Vinueza, Shayan Barootchi, Marc L Nevins, Myron Nevins, Richard J Miron, Lorenzo Tavelli","doi":"10.1111/prd.12522","DOIUrl":"10.1111/prd.12522","url":null,"abstract":"<p><p>Contemporary oral tissue engineering strategies involve recombinant human growth factor approaches to stimulate diverse cellular processes including cell differentiation, migration, recruitment, and proliferation at grafted areas. Recombinant human growth factor applications in oral hard and soft tissue regeneration have been progressively researched over the last 25 years. Growth factor-mediated surgical approaches aim to accelerate healing, tissue reconstruction, and patient recovery. Thus, regenerative approaches involving growth factors such as recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and recombinant human bone morphogenetic proteins (rhBMPs) have shown certain advantages over invasive traditional surgical approaches in severe hard and soft tissue defects. Several clinical studies assessed the outcomes of rhBMP-2 in diverse clinical applications for implant site development and bone augmentation. Current evidence regarding the clinical benefits of rhBMP-2 compared to conventional therapies is inconclusive. Nevertheless, it seems that rhBMP-2 can promote faster wound healing processes and enhance de novo bone formation, which may be particularly favorable in patients with compromised bone healing capacity or limited donor sites. rhPDGF-BB has been extensively applied for periodontal regenerative procedures and for the treatment of gingival recessions, showing consistent and positive outcomes. Nevertheless, current evidence regarding its benefits at implant and edentulous sites is limited. The present review explores and depicts the current applications, outcomes, and evidence-based clinical recommendations of rhPDGF-BB and rhBMPs for oral tissue regeneration.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"483-509"},"PeriodicalIF":18.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10185656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Periodontology 2000Pub Date : 2024-02-01Epub Date: 2023-08-24DOI: 10.1111/prd.12515
P A Miguez, E Bash, M L Musskopf, S A Tuin, A Rivera-Concepcion, I L C Chapple, J Liu
{"title":"Control of tissue homeostasis by the extracellular matrix: Synthetic heparan sulfate as a promising therapeutic for periodontal health and bone regeneration.","authors":"P A Miguez, E Bash, M L Musskopf, S A Tuin, A Rivera-Concepcion, I L C Chapple, J Liu","doi":"10.1111/prd.12515","DOIUrl":"10.1111/prd.12515","url":null,"abstract":"<p><p>Proteoglycans are core proteins associated with carbohydrate/sugar moieties that are highly variable in disaccharide composition, which dictates their function. These carbohydrates are named glycosaminoglycans, and they can be attached to proteoglycans or found free in tissues or on cell surfaces. Glycosaminoglycans such as hyaluronan, chondroitin sulfate, dermatan sulfate, keratan sulfate, and heparin/heparan sulfate have multiple functions including involvement in inflammation, immunity and connective tissue structure, and integrity. Heparan sulfate is a highly sulfated polysaccharide that is abundant in the periodontium including alveolar bone. Recent evidence supports the contention that heparan sulfate is an important player in modulating interactions between damage associated molecular patterns and inflammatory receptors expressed by various cell types. The structure of heparan sulfate is reported to dictate its function, thus, the utilization of a homogenous and structurally defined heparan sulfate polysaccharide for modulation of cell function offers therapeutic potential. Recently, a chemoenzymatic approach was developed to allow production of many structurally defined heparan sulfate carbohydrates. These oligosaccharides have been studied in various pathological inflammatory conditions to better understand their function and their potential application in promoting tissue homeostasis. We have observed that specific size and sulfation patterns can modulate inflammation and promote tissue maintenance including an anabolic effect in alveolar bone. Thus, new evidence provides a strong impetus to explore heparan sulfate as a potential novel therapeutic agent to treat periodontitis, support alveolar bone maintenance, and promote bone formation.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"510-531"},"PeriodicalIF":17.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10891305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10126461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Periodontology 2000Pub Date : 2024-02-01Epub Date: 2024-02-07DOI: 10.1111/prd.12551
Richard J Miron, Masako Fujioka-Kobayashi, Michael A Pikos, Toshiaki Nakamura, Takatomo Imafuji, Yufeng Zhang, Yukiya Shinohara, Anton Sculean, Yoshinori Shirakata
{"title":"The development of non-resorbable bone allografts: Biological background and clinical perspectives.","authors":"Richard J Miron, Masako Fujioka-Kobayashi, Michael A Pikos, Toshiaki Nakamura, Takatomo Imafuji, Yufeng Zhang, Yukiya Shinohara, Anton Sculean, Yoshinori Shirakata","doi":"10.1111/prd.12551","DOIUrl":"10.1111/prd.12551","url":null,"abstract":"<p><p>Bone grafts are typically categorized into four categories: autografts, allografts, xenografts, and synthetic alloplasts. While it was originally thought that all bone grafts should be slowly resorbed and replaced with native bone over time, accumulating evidence has in fact suggested that the use of nonresorbable xenografts is favored for certain clinical indications. Thus, many clinicians take advantage of the nonresorbable properties/features of xenografts for various clinical indications, such as contour augmentation, sinus grafting, and guided bone regeneration, which are often combined with allografts (e.g., human freeze-dried bone allografts [FDBAs] and human demineralized freeze-dried bone allografts [DFDBAs]). Thus, many clinicians have advocated different 50/50 or 70/30 ratios of allograft/xenograft combination approaches for various grafting procedures. Interestingly, many clinicians believe that one of the main reasons for the nonresorbability or low substitution rates of xenografts has to do with their foreign animal origin. Recent research has indicated that the sintering technique and heating conducted during their processing changes the dissolution rate of hydroxyapatite, leading to a state in which osteoclasts are no longer able to resorb (dissolve) the sintered bone. While many clinicians often combine nonresorbable xenografts with the bone-inducing properties of allografts for a variety of bone augmentation procedures, clinicians are forced to use two separate products owing to their origins (the FDA/CE does not allow the mixture of allografts with xenografts within the same dish/bottle). This has led to significant progress in understanding the dissolution rates of xenografts at various sintering temperature changes, which has since led to the breakthrough development of nonresorbable bone allografts sintered at similar temperatures to nonresorbable xenografts. The advantage of the nonresorbable bone allograft is that they can now be combined with standard allografts to create a single mixture combining the advantages of both allografts and xenografts while allowing the purchase and use of a single product. This review article presents the concept with evidence derived from a 52-week monkey study that demonstrated little to no resorption along with in vitro data supporting this novel technology as a \"next-generation\" biomaterial with optimized bone grafting material properties.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":"161-179"},"PeriodicalIF":18.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Disparities and social determinants of periodontal diseases.","authors":"Jasim M Albandar","doi":"10.1111/prd.12547","DOIUrl":"https://doi.org/10.1111/prd.12547","url":null,"abstract":"<p><p>Periodontal diseases are highly prevalent in populations worldwide and are a major global public health problem, with major negative impacts on individuals and communities. This study investigates evidence of disparities in periodontal diseases by age groups, gender, and socioeconomic factors. There is ample evidence that these diseases disproportionally affect poorer and marginalized groups and are closely associated with certain demographics and socioeconomic status. Disparities in periodontal health are associated with social inequalities, which in turn are caused by old age, gender inequality, income and education gaps, access to health care, social class, and other factors. In health care, these factors may result in some individuals receiving better and more professional care compared to others. This study also reviews the potential causes of these disparities and the means to bridge the gap in disease prevalence. Identifying and implementing effective strategies to eliminate inequities among minorities and marginalized groups in oral health status and dental care should be prioritized in populations globally.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":18.6,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mechanical plaque removal in step-1 of care.","authors":"G A Fridus Van der Weijden, Cor van Loveren","doi":"10.1111/prd.12541","DOIUrl":"https://doi.org/10.1111/prd.12541","url":null,"abstract":"<p><p>Maintaining a regular oral hygiene routine is essential for taking care of our mouths, ensuring healthy teeth, and achieving fresh breath. Patient education on oral hygiene is an important component of their overall treatment. Firstly, patients should be informed about the direct connection between bacteria in dental plaque and oral diseases. It is important for patients to understand that these conditions can be treated, but the success of treatment greatly depends on their level of oral hygiene. This journey begins by selecting the appropriate toothbrush and mastering the correct brushing technique to effectively remove dental plaque while avoiding any potential damage to the gums. In addition to toothbrushes, there are other devices available for comprehensive dental cleaning, such as floss, interdental sticks, interdental brushes, and oral irrigators. These aids are particularly beneficial for eliminating dental plaque from hard-to-reach areas. Moreover, tongue brushing or tongue scraping can effectively reduce breath odor and tongue coating. Currently, self-care recommendations for dental implants are primarily based on existing knowledge regarding natural teeth cleaning. Evidence-based recommendations are derived from comprehensive systematic evaluation of various oral hygiene aids.</p>","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":" ","pages":""},"PeriodicalIF":18.6,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giacomo Baima, Margherita Minoli, Dominique S. Michaud, Mario Aimetti, Mariano Sanz, Bruno G. Loos, Mario Romandini
{"title":"Periodontitis and risk of cancer: Mechanistic evidence","authors":"Giacomo Baima, Margherita Minoli, Dominique S. Michaud, Mario Aimetti, Mariano Sanz, Bruno G. Loos, Mario Romandini","doi":"10.1111/prd.12540","DOIUrl":"https://doi.org/10.1111/prd.12540","url":null,"abstract":"This review aims to critically analyze the pathways of interaction and the pathogenic mechanisms linking periodontitis and oral bacteria with the initiation/progression of cancer at different body compartments. A higher risk of head and neck cancer has been consistently associated with periodontitis. This relationship has been explained by the local promotion of dysbiosis, chronic inflammation, immune evasion, and direct (epi)genetic damage to epithelial cells by periodontal pathobionts and their toxins. Epidemiological reports have also studied a possible link between periodontitis and the incidence of other malignancies at distant sites, such as lung, breast, prostate, and digestive tract cancers. Mechanistically, different pathways have been involved, including the induction of a chronic systemic inflammatory state and the spreading of oral pathobionts with carcinogenic potential. Indeed, periodontitis may promote low-grade systemic inflammation and phenotypic changes in the mononuclear cells, leading to the release of free radicals and cytokines, as well as extracellular matrix degradation, which are all mechanisms involved in carcinogenic and metastatic processes. Moreover, the transient hematogenous spill out or micro-aspiration/swallowing of periodontal bacteria and their virulence factors (i.e., lipopolysaccharides, fimbriae), may lead to non-indigenous bacterial colonization of multiple microenvironments. These events may in turn replenish the tumor-associated microbiome and thus influence the molecular hallmarks of cancer. Particularly, specific strains of oral pathobionts (e.g., <i>Porphyromonas gingivalis</i> and <i>Fusobacterium nucleatum</i>) may translocate through the hematogenous and enteral routes, being implicated in esophageal, gastric, pancreatic, and colorectal tumorigenesis through the modulation of the gastrointestinal antitumor immune system (i.e., tumor-infiltrating T cells) and the increased expression of pro-inflammatory/oncogenic genes. Ultimately, the potential influence of common risk factors, relevant comorbidities, and upstream drivers, such as gerovulnerability to multiple diseases, in explaining the relationship cannot be disregarded. The evidence analyzed here emphasizes the possible relevance of periodontitis in cancer initiation/progression and stimulates future research endeavors.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"4 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138714178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Allan Radaic, Pachiyappan Kamarajan, Alex Cho, Sandy Wang, Guo-Chin Hung, Fereshteh Najarzadegan, David T. Wong, Hung Ton-That, Cun-Yu Wang, Yvonne L. Kapila
{"title":"Biological biomarkers of oral cancer","authors":"Allan Radaic, Pachiyappan Kamarajan, Alex Cho, Sandy Wang, Guo-Chin Hung, Fereshteh Najarzadegan, David T. Wong, Hung Ton-That, Cun-Yu Wang, Yvonne L. Kapila","doi":"10.1111/prd.12542","DOIUrl":"https://doi.org/10.1111/prd.12542","url":null,"abstract":"The oral squamous cell carcinoma (OSCC) 5 year survival rate of 41% has marginally improved in the last few years, with less than a 1% improvement per year from 2005 to 2017, with higher survival rates when detected at early stages. Based on histopathological grading of oral dysplasia, it is estimated that severe dysplasia has a malignant transformation rate of 7%–50%. Despite these numbers, oral dysplasia grading does not reliably predict its clinical behavior. Thus, more accurate markers predicting oral dysplasia progression to cancer would enable better targeting of these lesions for closer follow-up, especially in the early stages of the disease. In this context, molecular biomarkers derived from genetics, proteins, and metabolites play key roles in clinical oncology. These molecular signatures can help predict the likelihood of OSCC development and/or progression and have the potential to detect the disease at an early stage and, support treatment decision-making and predict treatment responsiveness. Also, identifying reliable biomarkers for OSCC detection that can be obtained non-invasively would enhance management of OSCC. This review will discuss biomarkers for OSCC that have emerged from different biological areas, including genomics, transcriptomics, proteomics, metabolomics, immunomics, and microbiomics.","PeriodicalId":19736,"journal":{"name":"Periodontology 2000","volume":"196 1","pages":""},"PeriodicalIF":18.6,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138571974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}