Pakistan Journal of Medical Sciences最新文献

{"title":"Comparative analysis of success rates and complications between lumbar microdiscectomy and open discectomy for lumbar disc herniation.","authors":"Zahid Khan, Seema Sharafat, Haider Ali","doi":"10.12669/pjms.41.4.10620","DOIUrl":"https://doi.org/10.12669/pjms.41.4.10620","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the success rates and complications associated with lumbar microdiscectomy compared to open discectomy from a tertiary care hospital perspective.</p><p><strong>Methods: </strong>A retrospective analysis was conducted at the Neurosurgery Department of Lady Reading Hospital over four years (January 2020 to December 2023). Inclusion criteria comprised patients of all genders and ages who underwent single-level lumbar microdiscectomy or open discectomy. Exclusion criteria encompassed patients who underwent redo surgeries, or had incomplete data.</p><p><strong>Results: </strong>In the study, 396 patients were enrolled, with 153 undergoing open discectomy and 243 undergoing microdiscectomy. The mean age of the participants was 40.42±11.49 years. Noteworthy findings from the analysis include that the success rates were 77.8% for open discectomy and 86.8% for microdiscectomy (p=0.050), while complications, specifically discitis, occurred in 2.6% of open discectomy patients and 0.4% of microdiscectomy patients (p=0.025).</p><p><strong>Conclusion: </strong>Microdiscectomy exhibited higher success rates and lower complication rates than open discectomy for single-level lumbar disc herniation, underscoring its potential as a preferred surgical intervention.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 4","pages":"992-996"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010801","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":"Geriatric nutritional risk index as a predictor of prognosis in hepatocellular carcinoma: A systematic review and meta-analysis.","authors":"Linfu Fang, Ziwei Chen","doi":"10.12669/pjms.41.4.11962","DOIUrl":"https://doi.org/10.12669/pjms.41.4.11962","url":null,"abstract":"<p><strong>Objective: </strong>The geriatric nutritional risk index (GNRI) has found utility as a predictor of outcomes in several malignancies. However, does it predicts outcomes in hepatocellular cancer (HCC) is unclear. In this review, we present high-quality evidence on the prognostic ability of GNRI for HCC.</p><p><strong>Methods: </strong>Two reviewers screened the websites of Embase, PubMed, Web of Science, and Scopus up to 20^th June 2024 for relevant articles. We examined overall survival (OS) and progression-free survival (PFS) based on low vs high GNRI in HCC.</p><p><strong>Results: </strong>Total 13 studies were included. Meta-analysis of 11 studies showed that low GNRI was significantly associated with poor OS (HR: 1.83 95% CI: 1.47, 2.29 I²=67%) and PFS (HR: 1.51 95% CI: 1.34, 1.69 I²=27%.) in HCC patients. No publication bias was noted. Most outcomes did not change on subgroup analysis based on country of origin, sample size, Child-Pugh Grade-B %, treatment, cut-off, follow-up, and method of analysis. Results remained significant on sensitivity analysis.</p><p><strong>Conclusions: </strong>The GNRI can predict OS and PFS in HCC patients. Given its availability and ease of calculation, the tool can be incorporated into clinical practice to rapidly predict the prognosis of HCC patients.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 4","pages":"1244-1252"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006246","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":"Controlling nutritional status score is a predictor of survival in hepatocellular carcinoma: A meta-analysis and meta-regression.","authors":"Yi Chen, Hong Cao, Jia Yao","doi":"10.12669/pjms.41.4.11660","DOIUrl":"https://doi.org/10.12669/pjms.41.4.11660","url":null,"abstract":"<p><strong>Objective: </strong>The controlling nutritional status score (CONUT) has been utilized for prognostication of several cancers but its utility for hepatocellular carcinoma (HCC) is still unclear. We reviewed evidence on the ability of CONUT to predict overall survival (OS) and disease-free survival (DFS) in patients with HCC.</p><p><strong>Methods: </strong>Online repositories of PubMed, Embase, CENTRAL, and Web of Science were searched by two reviewers for English language studies and were available before 15^th March 2024. Hazard ratio (HR) and 95% confidence intervals were calculated for both OS and DFS.</p><p><strong>Results: </strong>A total of fourteen studies were available. Meta-analysis showed that CONUT was a significant predictor for OS (HR: 1.64 95% CI: 1.30, 2.06) and DFS (HR: 1.32 95% CI: 1.17, 1.50) in HCC. The effect size failed to change in significance on sensitivity analysis. Subgroup analysis based on country and treatment of HCC did not change the results. Subgroup analysis and meta-regression showed that a higher CONUT cut-off led to a stronger association between CONUT and OS in HCC.</p><p><strong>Conclusions: </strong>CONUT can be an easy-to-use and rapid prognostic indicator for HCC. High CONUT scores are associated with worse OS and DFS.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 4","pages":"1226-1233"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007431","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":"Facilitators for Routine Medical Checkups Use from the Perspective of Primary Care Providers: A qualitative study.","authors":"Ali M Alzahrani, Baraa S Quronfulah, Holly C Felix, Asim A Khogeer","doi":"10.12669/pjms.41.4.10649","DOIUrl":"https://doi.org/10.12669/pjms.41.4.10649","url":null,"abstract":"<p><strong>Objective: </strong>To identify facilitators to routine medical checkups (RMCs) use among Saudi adults from the perspectives of primary care providers (PCPs).</p><p><strong>Methods: </strong>A qualitative phenomenological study design was conducted at five primary health care centers (PHCs) in Makkah, Saudi Arabia. Data was collected between December 2020 and February 2021 using semi-structured interviews with 19 PCPs. Descriptive statistics were performed to characterize participants, and a direct content analysis was conducted to identify major themes.</p><p><strong>Results: </strong>A number of factors were identified as facilitators for RMCs use among Saudi adults. Those facilitators were classified into three main themes related to patients, providers, and healthcare systems. Patients' knowledge about the importance of RMCs and their awareness of the service availability were identified as key facilitators under patients-related theme. Providers' knowledge, skills, and awareness of RMCs were identified as facilitators under provider-related themes. Lastly, improving the supply of providers and enhancing access were the facilitators identified under the healthcare system-related theme.</p><p><strong>Conclusion: </strong>This study provided insights into the facilitators for RMCs use among Saudi adults from the perspective of PCPs. This could contribute to the knowledge and inform future research, policy, and decision-making related to increasing the use of RMCs among Saudis.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 4","pages":"1023-1029"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005891","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":"Graves' disease in Children: A Case Report of Rare Occurrence.","authors":"Afia Tariq Butt, Ayaz Ur Rehman, Sobia Ramzan, Muzna Arif","doi":"10.12669/pjms.41.4.10689","DOIUrl":"https://doi.org/10.12669/pjms.41.4.10689","url":null,"abstract":"<p><p>Graves' disease (GD) is an autoimmune disorder that manifests as goiter, weight loss, heat intolerance, and palpitations. It is rare in preschool-aged children (<5 years) and can lead to serious acute and long-term complications, including growth and development, if left undiagnosed. We present the case of a four-year-old Hindu Asian girl from a low socioeconomic background who presented with progressive thyroid enlargement and symptoms of excessive sweating, heat intolerance, weight loss, diarrhea, fatigue, and palpitations over six months. Examination revealed symmetrical goiter, signs of thyrotoxicosis, bilateral exophthalmos, and raised blood pressure. Laboratory investigations confirmed Graves' disease with suppressed TSH, elevated T3 and free T4, and persistently high TSH receptor antibodies (TRAb >40 IU/L). She was started on carbimazole and propranolol, resulting in clinical improvement; however, biochemical parameters, including TRAb levels, remain persistently elevated at eight months and suppressed TSH at 13 months, indicating a high risk of relapse. Long-term ATD therapy will be continued, with definitive treatment (RAI or thyroidectomy) considered if remission is not achieved after three years. This case underscores the challenges of managing Graves' disease in young children and the need for prolonged monitoring and individualized treatment strategies.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 4","pages":"1253-1256"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977293","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":"The prognostic value of mean platelet volume levels in germinal matrix hemorrhage- intraventricular hemorrhage in preterm infants.","authors":"Ipek Guney Varal, Ezgi Deniz Acar Celik, Pelin Dogan, Gaffari Tunc, Ayse Oren","doi":"10.12669/pjms.41.4.11642","DOIUrl":"https://doi.org/10.12669/pjms.41.4.11642","url":null,"abstract":"<p><strong>Objective: </strong>Germinal matrix hemorrhage and intraventricular hemorrhage (GMH-IVH) is currently the most significant cause of brain damage and mortality seen in preterm infants. The aim of this study was to evaluate the predictive value of mean platelet volume (MPV) in diagnosing GMH-IVH and mortality.</p><p><strong>Method: </strong>A retrospective-cohort study of preterm infants with a gestational age <32 weeks or with birthweight <1500gr who were admitted to the Neonatal Intensive Care Unit was conducted between January 2020 and January 2022. These infants were then classified into two groups according to the presence of GMH-IVH.</p><p><strong>Results: </strong>Overall, 136 preterm infants were enrolled. The MPV levels were significantly higher in the GMH-IVH group (p <0.001). A MPV cutoff of >9.95 was determined to be predictive for GMH-IVH with sensitivity of 62% and specificity of 80% (p < 0.001). Mortality was significantly higher in the GMH-IVH group (p<0.001). A MPV cutoff of >10.55 fL was determined to predict mortality with 77% sensitivity and 70% specificity (p < 0.001).</p><p><strong>Conclusions: </strong>The MPV value is significantly higher in infants with GMH-IVH and therefore can be used in the prediction of GMH-IVH and mortality in preterm infants.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 4","pages":"1145-1150"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038242","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":"HBV infection and pregnancy: Increased risks of gestational diabetes and preterm birth.","authors":"Xiumei Cai, Suiping Huang, Zuliang Ma","doi":"10.12669/pjms.41.4.9578","DOIUrl":"https://doi.org/10.12669/pjms.41.4.9578","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of Hepatitis B virus (HBV) infection status on the outcomes of pregnancy.</p><p><strong>Methods: </strong>A retrospective study was conducted at Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde) from 1^st January 2020 to 31^st December2022.The study included 13,980 pregnant women, with 1,059 in the HBsAg-positive group (study group) and 12,921 in the HBsAg-negative group (control group). Pregnancy outcomes were compared between the control and study groups.</p><p><strong>Results: </strong>Pregnant women who tested positive for HBsAg had higher rates of gestational diabetes mellitus (P=0.019; OR, 1.20; 95% CI, 1.03-1.40), intrahepatic cholestasis of pregnancy (P=0.019; OR, 1.85; 95% CI, 1.11-3.09) and preterm birth before 34 weeks (P=0.013; OR, 1.96; 95% CI, 1.15-3.34). The relationship between HBV infection status with gestational diabetes mellitus, intrahepatic cholestasis of pregnancy and preterm birth before 34 weeks was significant.</p><p><strong>Conclusions: </strong>Pregnant women who tested positive for HBsAg faced a higher likelihood of developing gestational diabetes mellitus, intrahepatic cholestasis of pregnancy, and giving birth prematurely before 34 weeks. Further clarification is required regarding the influence of HBV infection on the outcomes of pregnancy.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 4","pages":"952-957"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035233","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":"Effects of different embryonic development days on clinical outcomes of freeze-thawed embryo transfer.","authors":"Nana Meng, Pengtao Li, Ting Liu, Jiawei Zhai, Meng-Yuan Guo","doi":"10.12669/pjms.41.4.9634","DOIUrl":"https://doi.org/10.12669/pjms.41.4.9634","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical outcome of freeze-thawed embryo transfer at different embryonic development days in whole embryo freezing patients of different ages.</p><p><strong>Methods: </strong>This was a retrospective study. Collected clinical data of 558 patients who underwent freeze-thawed embryo transfer at Reproductive Center of Baoding Maternal and Child Health Hospital from March 2019 to January 12, 2022. The enrolled patients were divided into two groups of 21~35 years old group(n=421) and 35~50 years old group(n=137) according to their ages. Then, three subgroups were established according to the development days of the freeze-thawed embryos under different age groups, D3 subgroup, D5 subgroup and D6 subgroup.</p><p><strong>Results: </strong>There were no significant differences in biochemical pregnancy rate, clinical pregnancy rate, multiple pregnancy rate, abortion rate, among the three groups in the 21~35 years old group. While significant difference was observed the highest embryo implantation rate in D5 subgroup(<i>P</i><0.05). Meanwhile, in 35~50 years old group, the biochemical pregnancy rate in D5 subgroup was significantly higher than that in D3 and D6 subgroups(<i>P</i><0.05). The clinical pregnancy rate of D5 subgroup was significantly higher than that of D6 subgroup(<i>P</i><0.05), and the clinical pregnancy rate of D5 subgroup was higher than that of D3 subgroup(<i>P</i>>0.05). The embryo implantation rate in D5 subgroup was significantly higher than that in D3 and D6 subgroups(<i>P</i><0.05).</p><p><strong>Conclusion: </strong>Compared with D3 and D6 transfer strategies, D5-blastocyst transfer exhibits more satisfactory clinical outcomes, with the highest clinical pregnancy and embryo implantation rates.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 4","pages":"1087-1091"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017142","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":"Comparison of performance of artificial intelligence tools in answering emergency medicine question pool: ChatGPT 4.0, Google Gemini and Microsoft Copilot.","authors":"Iskender Aksoy, Merve Kara Arslan","doi":"10.12669/pjms.41.4.11178","DOIUrl":"https://doi.org/10.12669/pjms.41.4.11178","url":null,"abstract":"<p><strong>Objective: </strong>Using artificial intelligence tools that work with different software architectures for both clinical and educational purposes in the medical field has been a subject of considerable interest recently. In this study, we compared the answers given by three different artificial intelligence chatbots to the Emergency Medicine question pool obtained from the questions asked in the Turkish National Medical Specialization Exam. We tried to investigate the effects on the answers given by classifying the questions in terms of content and form and examining the question sentences.</p><p><strong>Methods: </strong>The questions related to emergency medicine of the Medical Specialization Exam questions between 2015-2020 were recorded. The questions were asked to artificial intelligence models, including ChatGPT-4, Gemini, and Copilot. The length of the questions, the question type and the topics of the wrong answers were recorded.</p><p><strong>Results: </strong>The most successful chatbot in terms of total score was Microsoft Copilot (7.8% error margin), while the least successful was Google Gemini (22.9% error margin) (p<0.001). It was important that all chatbots had the highest error margins in questions about trauma and surgical approaches and made mistakes in burns and pediatrics. The increase in the error rates in questions containing the root \"probability\" also showed that the question style affected the answers given.</p><p><strong>Conclusions: </strong>Although chatbots show promising success in determining the correct answer, we think that they should not see chatbots as a primary source for the exam, but rather as a good auxiliary tool to support their learning processes.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 4","pages":"968-972"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041311","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":"Readiness for inter-professional education among healthcare professions students in Balochistan, Pakistan.","authors":"Sana Shah, Ahsan Sethi, Almas Khattak, Syed Muhammad Junaid","doi":"10.12669/pjms.41.4.10850","DOIUrl":"https://doi.org/10.12669/pjms.41.4.10850","url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to assess the readiness of undergraduate healthcare students in Balochistan, Pakistan's regarding Interprofessional Education (IPE). It also compared readiness across disciplines, academic years, and institutional settings.</p><p><strong>Methods: </strong>This analytical cross-sectional study was conducted among 374 undergraduate students from medical, nursing, physical therapy, and pharmacy programs across various institutions in Balochistan from March, 2021 to August, 2021. Data was collected using the \"Readiness for Interprofessional Learning Scale\" (RIPLS) to measure students' preparedness for IPE. Statistical analyses, including t-tests and ANOVA, were performed to examine differences in readiness based on gender, institutional setting, discipline, and academic year.</p><p><strong>Results: </strong>The total mean RIPLS score was 40.07 (SD=9.323), with subscale scores for teamwork and collaboration (15.89), negative professional identity (9.59), positive professional identity (7.48), and roles and responsibilities (7.10). No gender differences were found in RIPLS subscales, but private institution students had more negative professional identity perceptions (p=0.018). Significant differences in teamwork and collaboration (p<0.001) and positive professional identity (p=0.001) were observed across disciplines, with pharmacy students showing the highest scores. Year V students showed the highest readiness for teamwork (p<0.001) and Year III students had the highest positive professional identity (p=0.034).</p><p><strong>Conclusion: </strong>The study revealed an overall low level of readiness for IPE among healthcare students in Balochistan, with notable variations based on discipline and academic year. To improve IPE readiness, there is a need for enhanced integration of IPE principles into the curriculum, increased interprofessional interactions, and a focus on addressing the challenges specific to the region. Implementing these changes could better prepare students for collaborative practice and improve patient care outcomes.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":"41 4","pages":"1098-1104"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015367","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}