Peritoneal Dialysis International最新文献

{"title":"Response to \"Icodextrin lowers serum sodium in dose-dependent fashion: A case report\" : Keep calm and continue Icodextrin.","authors":"Marko Karakadze, Isaac Teitelbaum","doi":"10.1177/08968608251390265","DOIUrl":"10.1177/08968608251390265","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"413-414"},"PeriodicalIF":3.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145378259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic challenges in peritoneal dialysis-associated peritonitis with atypical and rare pathogens: A new era of metagenomic next-generation sequencing precision diagnosis.","authors":"Xiao Dong, Chao Xie, Zhe Zhang, Hongjian Ye, Ruihua Liu, Wei Chen, Yao-Zhong Kong, Xiao Yang","doi":"10.1177/08968608251333879","DOIUrl":"10.1177/08968608251333879","url":null,"abstract":"<p><p>Peritonitis caused by atypical and rare pathogens is challenging to diagnose. Although the International Society for Peritoneal Dialysis (ISPD) guidelines significantly improve the diagnostic rate by placing peritoneal dialysis fluid into blood culture bottles, peritonitis caused by atypical pathogens, such as tuberculosis and fungi, is difficult to diagnose due to challenges in culturing these organisms using traditional methods, leading to high mortality. Metagenomic next-generation sequencing (mNGS) technology has been widely used as an accurate diagnostic technique for infectious diseases. First used in identifying and quantifying environmental micro-organisms, mNGS technology can identify rare, novel, difficult-to-detect and mixed pathogens directly from clinical samples, and has potential in predicting antibiotic resistance. This paper summarizes the application of mNGS in atypical and rare pathogens peritonitis clinical cases in recent years, and provides reference for the diagnosis of peritonitis in combination with new ISPD guidelines and diagnostic techniques. The development and principles of mNGS technology, diagnostic efficiency in peritonitis, challenges in diagnosis of atypical and rare pathogen-associated peritonitis, and application of mNGS technology are discussed in detail. The development of mNGS technology provides clinicians with powerful tools to more accurately identify and treat peritonitis. Future research needs to focus on reducing costs, improving test accessibility, and developing new bioinformatics tools to better integrate mNGS results into clinical practice.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"315-324"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the costs and amount of recyclable polyvinyl chloride plastic waste associated with discarded Icodextrin.","authors":"Anukul Ghimire, Meera Shah, Elena Qirjazi, David Ward, Bhavneet Kahlon, Nikhil Shah, Karthik K Tennankore, Robert R Quinn, George Vitale","doi":"10.1177/08968608251344074","DOIUrl":"10.1177/08968608251344074","url":null,"abstract":"<p><p>There is limited data characterizing healthcare waste associated with peritoneal dialysis (PD). In Canada, Icodextrin for continuous cycling PD (CCPD) is only available as 2.5L bags for one-time use, and any remaining volume that is not used for a dwell is discarded. The environmental impact of this practice has not been well characterized. As such, we sought to estimate the costs associated with discarded Icodextrin and associated polyvinyl chloride (PVC) plastic waste production within our renal program. We conducted a cross-sectional audit of all patients utilizing CCPD in the Alberta Kidney Care South program in Canada in 2022. Icodextrin fill volume data were captured and the costs associated with Icodextrin use were calculated. Among patients on CCPD, the average fill volume for Icodextrin was 1273 mL, suggesting that an average of 1227 mL was discarded. In fact, 88% of patients used dwell volumes ≤1.5L. In 2021, our program spent $1.27 million CAD on Icodextrin for CCPD. Given that an average of 49% of each 2.5L bag was discarded, we estimate that the annual value of wasted Icodextrin among patients being treated with CCPD in our program was $622,300 CAD, or $3036 CAD per patient. Annual PVC waste was calculated to be 25.9 kg per patient, and we estimate that PVC waste could be reduced by 35% if there was access to 1.5L Icodextrin solutions. Our work suggests that the availability of Icodextrin bags that are better aligned with volumes used by patients could reduce healthcare costs and PVC waste.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"400-403"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of peritoneal dialysis fluids on arginine vasopressin dynamics in humans and transgenic rats.","authors":"Hiromichi Ueno, Yoichi Ueta, Yuki Nonaka, Tomohito Shirouzu, Naofumi Ikeda, Ikutaro Furuno, Kazutoshi Nakazono, Emi Hasegawa, Makiko Shimizu, Junichiro Koga, Takashi Maruyama, Tetsu Miyamoto, Masaharu Kataoka","doi":"10.1177/08968608251347093","DOIUrl":"10.1177/08968608251347093","url":null,"abstract":"<p><p>BackgroundFluid retention is a major complication of peritoneal dialysis (PD). Arginine vasopressin (AVP), an antidiuretic hormone, is known to be one of the important factors related to fluid management. However, the effect of the PD fluid (PDF) on AVP dynamics remains unclear.MethodsPlasma AVP levels and osmolality (direct measurement/calculation) were tested upon arrival. Next, we studied the effects of icodextrin-based PDF (I-PDF) and glucose-based PDF (G-PDF) on hypothalamic AVP synthesis in transgenic rats expressing AVP-enhanced green fluorescent protein (eGFP) under the AVP promoter.ResultsThe average plasma AVP levels in PD patients were higher than the normal range and patients with end-stage kidney disease (ESKD), however, the difference was not significant between PD and ESKD patients. In patients with PD, there is a significant correlation between plasma AVP levels and plasma osmolality (measured directly). In the G-PDF and I-PDF groups, eGFP fluorescence intensity increased in the paraventricular nucleus (PVN) and supraoptic nucleus (SON) of the hypothalamus, which are the main AVP synthesis sites. Immunohistochemical analysis revealed the expression of Fos protein, a useful indicator of neuronal activity, in eGFP-positive neurons in the PVN and SON after G-PDF administration.ConclusionTo the best of our knowledge, this is the first report demonstrating increased plasma AVP levels in patients with PD and upregulation of hypothalamic AVP after PDF administration in transgenic rats. This study revealed that osmotic changes during PD treatment strongly influence AVP dynamics. These findings provide new insights into fluid management in patients with PD.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"368-377"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to 'Icodextrin lowers serum sodium in dose-dependent fashion: A case report': Keep calm and continue icodextrin.","authors":"Jie Ming Nigel Fong, Pei Shan Lee","doi":"10.1177/08968608251381947","DOIUrl":"10.1177/08968608251381947","url":null,"abstract":"","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"410-412"},"PeriodicalIF":3.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145177493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritoneal dialysis effluent as a non-potable water resource: Biochemical and microbiological characterization compared to treated wastewater.","authors":"Clemente Cruz-Cruz, Leonel Pedro Román López, Marianela Paredes-Mendoza, Miguel Ángel Loyola-Cruz, Hiram José Serrano García, Emilio Mariano Durán-Manuel, Mayra Eugenia Avilés Ramírez, Julio César Juárez-Gómez, Octavio René García Flores, Claudia Camelia Calzada-Mendoza, Viridiana Galicia Galicia, Rocío Flores-Paz, Enzo Vásquez-Jiménez, Juan Manuel Bello-López","doi":"10.1177/08968608261415964","DOIUrl":"10.1177/08968608261415964","url":null,"abstract":"<p><p>BackgroundThe global water crisis poses challenges for water-intensive sectors, such as healthcare. In Mexico, continuous ambulatory peritoneal dialysis (CAPD) is used by almost half of patients on renal replacement therapy, generating significant volumes of peritoneal dialysis effluent (PDE) that are discarded without reuse. Unlike haemodialysis effluents, whose reuse has already been demonstrated, PDE lacks technical evidence regarding its biochemical and microbiological safety for potential non-potable applications. The objective of this study was to biochemically and microbiologically characterise the PDE generated by patients with chronic kidney disease in CAPD, comparing them with treated wastewater (TWW) and analysing their potential for non-potable reuse.MethodsPDEs obtained from CAPD patients were studied and compared with 18 TWW samples from urban and industrial plants. Biochemical parameters (glucose, creatinine, urea, uric acid, electrolytes, pH, and residual chlorine) and microbiological parameters (mesophilic bacteria, gram negative, gram positive, coliforms, and fungi) were analysed using automated methods and classical culture, respectively. Student's t test (<i>p</i> < 0.05) was used to determine significant differences between groups.ResultsThe PDE showed significantly higher concentrations of glucose (>750 mg/dL), urea, creatinine, and electrolytes compared to TWW (<i>p</i> < 0.0001), reflecting its hyperosmolar nature. The pH was neutral (∼7) and there was no residual chlorine. The complete absence of cultivable microbiological load in PDE was highlighted, unlike TWW, which presented significant elevated bacterial and fungal counts. These findings suggest a favourable microbiological profile of PDE, but a limiting biochemical load for its direct reuse.ConclusionPDE has potential for non-potable reuse, especially in agricultural or industrial applications, but requires advanced treatment such as reverse osmosis, nanofiltration, ultrafiltration, among others, to remove its high solute load. It is essential to create a specific regulatory framework for the reuse of this type of effluent, provided its safety is guaranteed.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"335-344"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146011704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes on peritoneal dialysis in patients with primary kidney disease related to multiple myeloma: A cohort study with data from the French Language Peritoneal Dialysis Registry.","authors":"Laura Jolec, Clémence Bechade, Antoine Lanot, Maxence Ficheux, Sonia Guillouet, Baptiste Delapierre, Thierry Lobbedez, Annabel Boyer","doi":"10.1177/08968608251357226","DOIUrl":"10.1177/08968608251357226","url":null,"abstract":"<p><p>BackgroundKidney impairment (KI) is a frequent complication of multiple myeloma (MM), with chronic kidney disease (CKD) often necessitating dialysis. Peritoneal dialysis (PD) offers quality-of-life advantages over haemodialysis (HD), yet its use in patients with CKD secondary to MM (CKD-MM) remains understudied. This study investigates the characteristics and outcomes of PD in CKD-MM patients compared to those with other kidney diseases.MethodsThis retrospective observational study analysed data from the French Language PD Registry (RDPLF) for patients initiating PD between 2010 and 2020. A 4:1 ratio random sampling was drawn from patients with other kidney diseases to create a control group. Outcomes included death, transfer to HD and kidney transplantation. Cox regression models assessed the impact of CKD-MM on these outcomes, adjusting for baseline variables and treatment era.ResultsOf 12,861 PD patients, 96 (<1%) had CKD-MM. These patients exhibited higher comorbidities and were less likely to be listed for kidney transplantation compared to controls. Among the 96 patients with CKD-MM, 51 (53%) died, 29 (30%) transferred to HD, and 5 (5%) underwent kidney transplant. CKD-MM was not associated with increased risks of death (cause-specific hazard ratio [cs-HR] 1.18, 95% CI 0.83-1.67) nor transfer to HD (cs-HR 0.73, 95% CI 0.45-1.18). However, CKD-MM patients had a significantly lower chance of transplantation (cs-HR 0.22, 95% CI 0.08-0.59).ConclusionPD is a viable modality for CKD-MM, with outcomes comparable to other kidney diseases. Increased attention to PD initiation and transplant access may further optimise care for these patients.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"386-395"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe symptomatic hypocalcemia and prolonged heart failure after treatment of osteoporosis with denosumab in a peritoneal dialysis patient: A case report.","authors":"Keisuke Yoshida, Shigeki Kojima, Tsutomu Sakurada","doi":"10.1177/08968608251361322","DOIUrl":"10.1177/08968608251361322","url":null,"abstract":"<p><p>Patients with dialysis have a high risk of osteoporosis and fractures. However, the optimal treatment strategies for osteoporosis in dialysis patients remain unclear due to the complexity of chronic kidney disease (CKD)-mineral and bone disorder. This case report describes severe symptomatic hypocalcemia and prolonged heart failure following denosumab treatment in a peritoneal dialysis (PD) patient with secondary hyperparathyroidism and osteoporosis. A 70-year-old woman on PD for dialysis caused by diabetic nephropathy was diagnosed with osteoporosis (T score -2.5) during a routine checkup. Denosumab, a receptor activator of nuclear factor kappa-B ligand (RANKL) inhibitor, was administered following an increase in active vitamin D analog levels. One month later, she developed tetany, making it difficult to perform PD. Two days later, she was hospitalized with breathing difficulties and diagnosed with severe hypocalcemia and heart failure. Heart failure was attributed to mild fluid overload and reduced cardiac contractility due to hypocalcemia. Treatment with calcium supplementation and hemodialysis alleviated her symptoms and improved cardiac function. Denosumab is a promising option for osteoporosis in dialysis patients, but it poses a significant risk of severe hypocalcemia, especially in those with secondary hyperparathyroidism. Reports of such complications in PD patients are rare. Clinicians should carefully monitor serum calcium levels, implement preventive strategies, and promptly address complications when using denosumab in this population. In this case, cardiac function remained impaired for at least 6 months, suggesting prolonged heart failure following denosumab-associated hypocalcemia.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"396-399"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypokalaemia and peritoneal dialysis-related peritonitis: Association, risk factors and outcomes.","authors":"Shabana Kalla, David W Johnson, Christine Chang, Marguerite Conley, Carmel Hawley, Carolyn van Eps, Yeoungjee Cho","doi":"10.1177/08968608251352634","DOIUrl":"10.1177/08968608251352634","url":null,"abstract":"<p><p>BackgroundPeritonitis is a serious complication associated with risks of death and transfer to haemodialysis for patients receiving peritoneal dialysis (PD). To mitigate such risks, it is important to identify potentially reversible risk factors, such as hypokalaemia.MethodPatients who started PD at the Princess Alexandra Hospital, Australia from 1^st January 2013 to 31^st December 2022 were included. Hypokalaemia, defined as serum potassium <3.5 mmol/L, was assessed at the time of PD initiation and evaluated as categories (<3.5 mmol/L, 3.5-4.5 mmol/L and >4.5 mmol/L) based on 6-month average after PD commencement. Time to first peritonitis was examined using multi-variable Cox survival analyses censored for transplantation, recovery of kidney function or loss to follow up. Competing risk regression was conducted as sensitivity analysis. Peritonitis rates were compared using Poisson regression analysis.ResultsIn total, 486 patients were included. 6-Month average serum potassium level was <3.5 mmol/L in 30 patients (6.2%), 3.5-4.5 mmol/L in 301 patients (62%) and >4.5 mmol/L in 155 patients (32%). During the study period, 192 patients experienced peritonitis with comparable proportions across all three groups (35%, 40% and 40%, respectively). Using multi-variable regression modelling, we found that time to first peritonitis was not significantly associated with hypokalaemia based on 6-month average (hazard ratio 1.14, 95% confidence interval [CI] 0.67-1.95) or baseline hypokalaemia (hazard ratio 0.73, 95% CI 0.34-1.54). Using the categories based on 6-month average serum potassium level, mean peritonitis rate was higher among patients in the <3.5 mmol/L group (0.79 episodes/patient-year) compared to those in the 3.5-4.5 mmol/L (0.61 episodes/patient-year) and >4.5 mmol/L (0.47 episodes/patient-year), whilst the difference was not significant (<i>p</i> = 0.14).ConclusionIn this study, no significant association was identified between hypokalaemia and risk of peritonitis, although estimates were imprecise.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"378-385"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainable kidney care: A life cycle assessment of the peritoneal dialysis pathways.","authors":"James Larkin, Giulia Ligabue, Gaetano Alfano, Rodrigo Martínez Cadenas, Abass Fehintola, Ingeborg Steinbach, Aycan Yasar, Niccolo Morisi, Marta Arias-Guillen, Marialuisa Caiazzo, Gabriele Donati, Brett Duane","doi":"10.1177/08968608251415439","DOIUrl":"10.1177/08968608251415439","url":null,"abstract":"<p><p>BackgroundPeritoneal dialysis (PD) is a home-based treatment for kidney failure, offering significant social, economic and environmental advantages over haemodialysis (HD). It allows patients greater independence and flexibility, can reduce healthcare costs in some settings, and is reported to generate a smaller environmental footprint compared to HD. However, despite this, its environmental impact, particularly in terms of resource use and waste generation, is an area of growing concern. Evaluating PD through a sustainability lens, considering environmental, social, health and economic dimensions is crucial to improving its long-term viability and reducing the healthcare sector's environmental footprint.MethodsAn LCA of the PD treatment pathway was conducted at the Nephrology Dialysis and Kidney Transplantation Unit, 'Azienda Ospedaliero-Universitaria (AOU), Policlinico di Modena, Italy. Data were collected between April and July 2024 and was categorised into 17 PD-related procedures. Key activities assessed were electricity use, resource consumption (procurement), water consumption, patient and staff travel and waste disposal. Flow diagrams were created to model the PD pathway and product components were dismantled and weighed to determine material contributions. Environmental impacts were analysed using OpenLCA and the Ecoinvent database.ResultsAutomated peritoneal dialysis (APD) treatments produced greater emissions than continuous ambulatory peritoneal dialysis (CAPD), primarily due to higher electricity consumption and the use of polyvinylchloride. APD generated 3267 kg CO₂e annually compared to 2975 kg CO₂e for CAPD. Monthly patient examinations contributed 250 kg CO₂e per year, largely from travel. CAPD produced more healthcare waste (320 kg), leading to 810 kg CO₂e emissions, while APD waste emissions were lower at 374 kg CO₂e. Incremental dialysis approaches showed substantial reductions, with emissions falling to 1642 kg CO₂e (APD) and 1517 kg CO₂e (CAPD). The most impactful materials included polyethylene and PVC, with plastic components contributing significantly to overall emissions.ConclusionThis comprehensive life cycle assessment (LCA) highlights the environmental challenges associated with PD, particularly in waste generation and resource use. Key areas for improvement include reducing single-use plastic reliance, increasing recycling efforts and integrating energy-efficient solutions. This study provides a foundation for targeted sustainability interventions in PD and contributes to the broader goals of the KitNewCare project, which aims to optimise health outcomes while minimising environmental impacts in kidney care.</p>","PeriodicalId":19969,"journal":{"name":"Peritoneal Dialysis International","volume":" ","pages":"325-334"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}