Pediatric Cardiology最新文献

{"title":"Isomeric Bodily Situs in the Era of Universal Prenatal Detection: Highlighting Computed Tomographic Findings in Those with Complex Cardiovascular Malformations.","authors":"William N Evans, Ruben J Acherman, Dean Berthoty, Gary A Mayman, Humberto Restrepo","doi":"10.1007/s00246-025-04059-1","DOIUrl":"https://doi.org/10.1007/s00246-025-04059-1","url":null,"abstract":"<p><p>Primarily to identify those with isomeric bodily situs and complex cardiovascular malformations (CCVMs) diagnosed pre- and postnatally from January 2010-December 2024 and report anatomical findings from computed tomography (CT). We identified isomeric bodily situs by ultrasound of upper abdominal inferior caval vein-descending aorta relationships. We identified 91 cases: 65 (71%) with left-isomeric (LI) and 26 (29%) with right-isomeric (RI) bodily situs. Of the 91, 87 had prenatal care, and 86 (99%) were prenatally diagnosed; however, 100% of those with CCVMs were prenatally diagnosed. Of the 91, 78 were live-born. Of the 78, 34 with LI bodily situs had no CCVM, and 44 (24 with LI and 20 with RI) had CCVM. Of the 44, 42 underwent a surgical procedure, and 31/42 (74%) had a preoperative CT scan. Of the 31, 14 had LI bodily situs, in which 79% had left atrial appendage isomerism (LAAI), 79% had left bronchial isomerism, 71% had polysplenia, and 64% had a transverse liver. Of the 31, 17 had RI bodily situs, in which 64% had right atrial appendage isomerism (RAAI), 59% had right bronchial isomerism, 82% had asplenia, and 82% had a transverse liver. Isomeric situses manifest heterogenic thoracoabdominal anatomical features; however, the majority with LI bodily situs had LAAI, left bronchial isomerism, polysplenia, and a transverse liver; and the majority with RI bodily situs had RAAI, right bronchial isomerism, asplenia, and a transverse liver. Further, the prenatal diagnosis was universal in Nevada for those with isomeric bodily situs and CCVMs.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252271","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":"Clinical and Experimental Studies of Structural Valve Degeneration of Bovine Jugular Vein Valves: Mitigation with Polyoxazoline Modification.","authors":"Morgan K Moroi, Yaagnik Kosuri, Sameer K Singh, Yingfei Xue, Andrey Zakharchenko, Cary Karcher, Alexis Martinez, Krushang Patel, Alexey Abramov, Chrystalle Katte Carreon, Stephen P Sanders, Robert J Levy, Giovanni Ferrari","doi":"10.1007/s00246-025-04052-8","DOIUrl":"https://doi.org/10.1007/s00246-025-04052-8","url":null,"abstract":"<p><p>Bovine jugular vein (BJV) valves are widely used in congenital heart surgery but are limited in durability due to structural valve degeneration (SVD). Here, we examine mechanisms of BJV prosthesis failure and test BJV modification with poly-2-methyl-2-oxazoline (POZ), a polymer shown to inhibit protein and advanced glycation end-product (AGE) absorption. Clinical BJV valve explants (Melody valve, N = 13) underwent Von Kossa staining and immunohistochemistry (IHC) for AGE, carboxymethyllysine (CML), and serum albumin (SA). Collagen structure was analyzed using second-harmonic generation (SHG) imaging. Unmodified and POZ-modified BJV valved conduits underwent 5-week in vitro glycation incubation. Effective orifice area (EOA) and mean pressure gradient (MPG) were recorded weekly using a heart pulse duplicator system. Following incubation, leaflet thickness, IHC, and SHG analyses were performed. In vivo 28-day subcutaneous BJV leaflet implantations were performed in juvenile rats for IHC. Clinical BJV explants demonstrated AGE, CML, and SA infiltration. In vitro glycation induced leaflet thickening (control, 0.03 ± 0.01 vs non-modified, 0.23 ± 0.07 mm, p < 0.001), CML and SA infiltration, and collagen disruption (alignment coefficient: control, 0.76 ± 0.03 vs non-modified, 0.50 ± 0.19, p < 0.01). POZ-modified leaflets remained similar in thickness to unglycated controls. POZ modification reduced CML and SA accumulation and mitigated collagen malalignment. BJV conduits did not reveal clinically significant changes in MPG or EOA. In vivo studies verified POZ modification protected against microcalcification as well as AGE, CML, and SA deposition. BJV valves are subject to SVD-related mechanisms of AGE accumulation, serum protein infiltration, and collagen misalignment. POZ modification mitigates BJV leaflet thickening, AGE and protein infiltration, and collagen disruption.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252199","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":"Surgical Outcomes in Adolescent and Adult Congenital Heart Disease: Identifying Predictors of Major Adverse Events.","authors":"Ming Chern Leong, Muhammad Kamran Younis Memon, Nurul Fazira Basran, Nor Athirah Azeman, Yee Chen Tho, Kok Wai Soo","doi":"10.1007/s00246-025-04056-4","DOIUrl":"https://doi.org/10.1007/s00246-025-04056-4","url":null,"abstract":"<p><p>Surgical outcome data on adolescent and adult congenital heart disease (CHD) undergoing cardiac surgery remains scarce in developing economies. The study aims to evaluate the clinical characteristics and postoperative outcomes in this population, with a focus on identifying risk factors to guide quality improvement initiatives. This retrospective cohort study analyzed 569 CHD patients (aged > 12 years) who underwent surgery at a tertiary center (2018-2023). Data included demographics, surgical details, and clinical outcomes. Major adverse events (MAEs) were defined as cardiopulmonary resuscitation, chest reopening for resuscitation, extracorporeal membrane oxygenation, or death. Univariate and multivariate logistic regressions were performed to identify predictors of MAEs. The median age at surgery was 19.7 years; 42.4% underwent redo sternotomy. Complications occurred in 60.1% of patients, with MAEs in 4.9% and mortality in 2.1%. Multivariate analysis identified significant postoperative bleeding (OR 583.62, 95% CI 16.24-20,970.32) as the main predictor of MAEs. Redo sternotomy doubled the risk of a significant postoperative bleeding (15.4% vs. 6.7%, p < 0.001). The strong association between redo sternotomy, significant postoperative bleeding and MAEs provided the evidence base for a focused quality initiative. The findings served as the direct impetus for developing and implementing a multidisciplinary institutional protocol aimed at mitigating this primary risk. This structured framework offers a replicable model for programs in other resource-limited settings.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252331","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":"In Utero Diagnosis of Premature Closure of the Foramen Ovale: A Retrospective Case Series Analyzing Neonatal Interventions and Maternal Factors.","authors":"Emily Kadish, Dina Simon, Rakhee Bowker, Cyndi Sosnowski, Suhagi Kadakia","doi":"10.1007/s00246-025-04055-5","DOIUrl":"https://doi.org/10.1007/s00246-025-04055-5","url":null,"abstract":"<p><p>Isolated premature closure of the foramen ovale (FO) in utero is a rare condition. The impact on fetal hemodynamics and postnatal outcomes varies greatly, with most severe outcomes including: arrhythmias, heart failure, and hydrops fetalis. We sought to analyze the types of interventions that neonates diagnosed prenatally with isolated premature FO closure receive post-birth and to identify associated maternal factors. A retrospective chart review was conducted at an urban level II fetal center from January 1st, 2018 to April 30th, 2025. 34 subjects were identified with premature closure of the FO on fetal echocardiogram. Of those, 100% received a postnatal echocardiogram and 56% required cardiology follow-up with a repeat echocardiogram. Postnatal echocardiogram findings included restricted patent FO with left-to-right shunt, small ASD, aneurysmal atrial septum, and normal imaging; none showed complete closure of the FO. Of the neonates in this review, 62% required neonatal intensive care unit (NICU) admission, 29% required continuous positive airway pressure, 21% required intravenous fluids, and 6% required milrinone; no subjects required inhaled nitric oxide or extracorporeal membrane oxygenation (ECMO). Potential maternal associations identified included diabetes (26%), hypertension (18%), and aspirin use (35%). We conclude that prenatal diagnosis of premature FO closure is essential given all the subjects required postnatal echocardiogram monitoring and access to pediatric cardiology. Future studies should broaden the sample size across multiple institutions to better identify predisposing maternal factors and determine updated guidelines for prenatal echocardiogram screening to monitor for premature closure or restriction of the FO.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252260","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":"Clarifying the Cardiovascular Morphology and Associated Abnormalities in Patients with Double Inlet Left Ventricle Using Multidetector CT Angiography.","authors":"Niraj Nirmal Pandey, Mansi Verma, Sheetal Sharma, Damandeep Singh, Vineeta Ojha, Sanjeev Kumar, Sivasubramanian Ramakrishnan, Priya Jagia","doi":"10.1007/s00246-025-04053-7","DOIUrl":"https://doi.org/10.1007/s00246-025-04053-7","url":null,"abstract":"<p><p>The present study sought to evaluate the intracardiac morphology and associated cardiovascular anomalies in patients with double inlet left ventricle (DILV) on multidetector CT angiography. A retrospective search of the electronic departmental database was conducted from January 2014 to January 2023 to identify patients with a diagnosis of DILV on cardiac CT angiography. Patients with a common atrioventricular valve were excluded. The scans were systematically reviewed in a sequential segmental fashion for evaluating the intracardiac morphology and associated cardiovascular abnormalities. DILV was identified in 97 patients (74 males; mean age: 5.15 years). A hypoplastic right ventricular cavity was seen in all patients. The most prevalent ventriculo-arterial configuration was transposition of great arteries seen in 60/97 (61.9%) patients. Concordant ventriculo-arterial connections (Holmes heart) were observed in 17/97 (17.5%) patients while double outlet right ventricle and origin of aorta from right ventricle with pulmonary atresia were seen in 8/97 (8.2%) patients respectively. Aortic arch anomalies were seen in 11/97 (11.3%) patients. Type A interrupted aortic arch was present in 1 (1%) patient, and 2 (2.1%) patients had aortic stenosis. Some form of pulmonary outflow obstruction was seen in 45/97 (46.4%). Pulmonary atresia was observed in 11/97 (11.3%) patients out of which 1 had non-confluent pulmonary arteries. Pulmonary venous anomalies were observed in 4/97 (4.1%) patients. A single coronary artery was seen in 6/97 (6.2%) patients. DILV is a congenital heart disease with functionally single ventricle and is associated with a wide variety of cardiovascular anomalies, most commonly transposition of great arteries and pulmonary outflow tract obstruction. Multidetector CT angiography is an excellent modality for detailed intracardiac anatomical evaluation and depiction of associated cardiovascular anomalies which may aid in deciding the surgical approach.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145239396","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":"Re-interventions Following Patent Ductus Arteriosus Stenting During the Inter-stage Period.","authors":"James R Bentham, Sok-Leng Kang","doi":"10.1007/s00246-025-04029-7","DOIUrl":"https://doi.org/10.1007/s00246-025-04029-7","url":null,"abstract":"<p><p>Stenting of the arterial duct is an established alternative to surgical palliation for infants with duct-dependent congenital heart disease but is often associated with the need for reintervention to achieve a result through to the next stage surgery. The relatively high rate of interstage reintervention is partly related to increased anatomic and procedural complexity but with growing experience planned reinterventions to optimize vessel and somatic growth is also possible. We discuss the challenges encountered when reintervening on stented ducts and technical considerations to increase procedural efficiency and mitigate complications in these small infants.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225737","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":"Gaps in Pediatric Interventional Cardiology Technology: A Survey Assessment.","authors":"Daniel Levi, Nicholas Sharawy, Tim Moran","doi":"10.1007/s00246-025-04046-6","DOIUrl":"https://doi.org/10.1007/s00246-025-04046-6","url":null,"abstract":"<p><p>As a follow-up to the device needs survey conducted and published in 2015, an updated survey was repeated in 2024 to evaluate gaps in device and equipment availability for pediatric congenital interventional cardiologists. Over 200 US pediatric interventional cardiologists were contacted directly via email. The Congenital Cardiovascular Interventional Study Consortium (CCISC) and the Pediatric and Congenital Interventional Cardiovascular Society (PICS) distributed the survey to its membership in the United States (US). Respondents cited a need for new devices which differed significantly from the 2015 survey. \"Biodegradable Stents\" (37%), \"PDA Stents\" (patent ductus arteriosus, 21%), and \"Pulmonary Artery Flow Restrictors\" (21%) were ranked as the top three most needed devices. Devices that were suspected to offer the greatest potential reduction in mortality were \"Flow Restrictors\" (30%), \"PDA Stents\" (18%), and \"Biodegradable Stents\" (6%). The respondents also prioritized the needs for devices not available in the US or removed from the market. With many startups and larger companies interested in the congenital interventional space, the results of this survey are intended to help guide tailored device development for the most pressing needs of the congenital interventional cardiology community.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213333","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":"Evaluation of Cardiac Function in Children Undergoing Liver Transplantation.","authors":"Neha Bansal, Joseph Mahgerefteh, Jacqueline M Lamour, Debora Kogan-Liberman, Michelle Ovchinsky, Kayla Ganzburg, Nadine Choueiter","doi":"10.1007/s00246-024-03673-9","DOIUrl":"10.1007/s00246-024-03673-9","url":null,"abstract":"<p><p>Cirrhotic cardiomyopathy is a complication of cirrhosis resulting in cardiac dysfunction. It remains poorly characterized in children. The aim of this study was to assess relationship of pre-liver transplant (LT) conventional and novel parameters of biventricular function with post-LT clinical course. This is a retrospective study of pre-LT echocardiograms performed on patients < 18 years of age with cirrhosis at a single center, who received a LT. Demographic, clinical, and echocardiographic data were collected. Speckle tracking echocardiography (STE) analysis was performed by a single observer using TomTec system. Descriptive data were expressed as mean (SD) and number (%). The relationship between clinical data and echocardiographic variables were assessed using Spearman correlation coefficient. Significance was set at < 0.05. Thirty-five patients (median age 6.5; IQR 14.2 years) underwent LT between 2010 and 2020. Pre-LT diagnosis was biliary atresia in 14 (40%) patients and 7 (20%) patients were listed as status 1A/1B. Their median natural pediatric/model end-stage liver disease score was 13 (IQR 9). Their pre-LT echocardiogram showed normal left ventricular systolic (LV) function by ejection fraction and strain parameters. Right ventricular (RV) function was abnormal in 74% of patients as measured by RV GLS (23 ± 3%). There was correlation between echocardiographic parameters with pre-transplant clinical disease and post-operative LT course (length of stay and duration of mechanical ventilation). Children undergoing liver transplant have RV dysfunction as evidenced by abnormal RV GLS on STE. There is echocardiographic parameter correlation between clinical liver disease and post-LT clinical course. This evidence highlights the importance of using novel technology like STE in assessment of children undergoing evaluation for liver transplant.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"2019-2026"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VSD Surgical Closure in Colombia in Children with Secondary Pulmonary Hypertension. Does Altitude Influence Postoperative Pulmonary Pressure?","authors":"Linibeth Cruz-Baquero, Nicolas Molano-Gonzalez, Daniel García-Vargas, Alberto García Torres","doi":"10.1007/s00246-024-03697-1","DOIUrl":"10.1007/s00246-024-03697-1","url":null,"abstract":"<p><p>A retrospective, cross-sectional, descriptive, observational study was carried out to describe the history of pulmonary hypertension in pediatric patients living at different altitudes following surgical correction of ventricular septal defect. Data from 40 patients who underwent surgery in La Fundacion Cardioinfantil was collected and used for our analysis. Bivariate analysis showed no significant relationship between altitude and pulmonary hypertension after ventricular septal defect closure. Unrelated to the main objective of our study, our investigation revealed that our population underwent surgical correction of VSD at older ages than expected. While previous publications demonstrate the benefit of intervention at 4 years of age or younger (19, 20), the average age in our studied population was found to be 7.8 years old. These patients had unfavorable hemodynamic parameters for ventricular septal defect closure, but our study showed that our patients benefited from surgery with an immediate satisfactory postoperative result. Patients transitioned from parameters indicating severe PH to mild PH within the first 24-48 h after surgery.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"1968-1973"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition Provision in Children with Heart Disease on Extracorporeal Membrane Oxygenation (ECMO).","authors":"Jason S Kerstein, Caroline R Pane, Lynn A Sleeper, Emily Finnan, Ravi R Thiagarajan, Nilesh M Mehta, Kimberly I Mills","doi":"10.1007/s00246-024-03628-0","DOIUrl":"10.1007/s00246-024-03628-0","url":null,"abstract":"<p><p>Nutrition provision for children with heart disease supported with extracorporeal membrane oxygenation (ECMO) involves nuanced decision making. We examined nutrition provision while on ECMO in the CICU and the relationship between energy and protein adequacy and end organ function as assessed by pediatric sequential organ failure assessment (pSOFA) scores in children with heart disease supported with ECMO. Children (≤ 21 years-old) with congenital or acquired heart disease who received ECMO in the cardiac intensive care unit were included. There were 259 ECMO runs in 252 patients over an 8-year study period (2013-2020). Median energy delivery and adequacy were 26.1 [8.4, 45.9] kcal/kg/day and 58.3 [19.8, 94.6]%, respectively. Median protein delivery and adequacy were 0.98 [0.36, 1.64] g/kg/day and 35.7 [13.4, 60.3]%, respectively. pSOFA increased by a median of four points during the ECMO run. Change in pSOFA score was not associated with energy or protein adequacy (p = 0.46 and p = 0.72, respectively). Higher energy and protein adequacy-from parenteral nutrition-correlated with increased hospital-acquired infections (HAIs, p = 0.031 and p = 0.003, respectively). Achieving nutritional adequacy was dependent on the use of parenteral nutrition. Similar clinical outcomes with regard to end organ function but with an increased incidence of HAIs suggests the need to explore the role of optimal enteral nutrition delivery on ECMO.</p>","PeriodicalId":19814,"journal":{"name":"Pediatric Cardiology","volume":" ","pages":"2097-2106"},"PeriodicalIF":1.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056249","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}