PM&R最新文献

{"title":"Overall outcome, functioning, and disability in older adults 3 to 14 years after traumatic brain injury.","authors":"Charlotta von Seth, Anders Lewén, Marianne Lannsjö, Per Enblad, Jan Lexell","doi":"10.1002/pmrj.70012","DOIUrl":"https://doi.org/10.1002/pmrj.70012","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological studies show an increasing incidence of traumatic brain injury (TBI) among people aged 65 years and older. Advances in neurointensive care have improved survival after TBI. There is a need for knowledge about long-term outcome after TBI among older survivors of TBI.</p><p><strong>Objective: </strong>To describe the overall outcome, long-term functioning, and disability of the participants in the Uppsala Long-term outcome in Older adults with Traumatic brain injury Study (U-LOTS), a cohort study assessing adults aged 60 years or older when admitted to a neurointensive care unit following a TBI, where 3 to 14 years had passed since the injury.</p><p><strong>Design: </strong>Cross-sectional cohort study.</p><p><strong>Setting: </strong>Home and community settings.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Participants: </strong>Data were collected from 79 survivors of TBI (65% men; mean age 76 years, mean time since TBI 7 years).</p><p><strong>Main outcome measures: </strong>The Glasgow Outcome Scale Extended (GOSE), the Functional Independence Measure (FIM), the Mayo-Portland Adaptability-4 (MPAI-4), and the following sociodemographics and TBI characteristics: gender, age, marital status, vocational situation, rehabilitation, need of assistance, use of mobility devices, oropharyngeal dysphagia, impaired sense of smell and/or taste, prior brain disease, cause of accident, severity of TBI, comorbidities, dominant finding on first computed tomography scan, and assessment with GOSE 6 months after TBI.</p><p><strong>Results: </strong>Falls (68%) and acute subdural hematoma (41%) were the most common cause and injury. For many participants (40%) the GOSE scores did not change between 6 months after TBI until the long-term follow-up, and a majority (57%) had a relatively good outcome as assessed with the MPAI-4. GOSE, FIM, and MPAI-4 Ability scores were significantly (p < .05) correlated with injury severity. Marital status remained unchanged for 70% of the participants.</p><p><strong>Conclusions: </strong>Older adults surviving a TBI may have a relatively favorable outcome. A major factor that determined long-term outcome was injury severity.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086095","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":"Physiatrists as champions for a unified field of limb loss, difference, and preservation rehabilitation (LDPR)-perspectives on challenges and interventions.","authors":"Prateek Grover, Marlís González Fernández","doi":"10.1002/pmrj.70016","DOIUrl":"https://doi.org/10.1002/pmrj.70016","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070383","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":"Occult presentation of spinal epidural abscess.","authors":"Rotem Hass, Vincenzo Pizzuti, Ashley Petrone, Brett Begley","doi":"10.1002/pmrj.70025","DOIUrl":"https://doi.org/10.1002/pmrj.70025","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065165","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":"Virtual reality glove for home-based hand and arm stroke rehabilitation (vREHAB).","authors":"Ling Yan, Julie Muccini, Leonel Lugo, Michael Mlynash, Laura Michiels, Geert Verheyden, Leen Saenen, Benjamin Dirlikov, Arshad Ali, Julie Lanphere, Henry Huie, Robin Lemmens, Maarten G Lansberg","doi":"10.1002/pmrj.70014","DOIUrl":"https://doi.org/10.1002/pmrj.70014","url":null,"abstract":"<p><strong>Background: </strong>Upper extremity impairment is common after stroke. Virtual-reality rehabilitation systems may help restore hand and arm function.</p><p><strong>Objective: </strong>To assess the feasibility of the Neofect Smart Glove and its effect on functional recovery.</p><p><strong>Design: </strong>Multicenter, prospective, randomized, open-label, blinded-endpoint phase 2 trial consisting of a 12-week active treatment period followed by a 12-week follow-up period.</p><p><strong>Study population: </strong>Patients with subacute and chronic stroke with upper extremity impairment.</p><p><strong>Interventions: </strong>Patients assigned to the intervention group were instructed to use the Smart Glove for a minimum of one session per day for at least 5 days per week during the 12-week active treatment period, in addition to their usual care. Patients in the control group received their usual care only.</p><p><strong>Outcomes: </strong>Feasibility was assessed by the total dose of rehabilitation. The change from baseline to week 12 on the Jebsen-Taylor Hand Function Test (JTHFT) was the primary efficacy outcome and the change on the Upper Extremity Fugl-Meyer Assessment (UE-FMA) was secondary.</p><p><strong>Statistics: </strong>Differences between treatment arms were compared using analysis of covariance in the overall population and, separately, in a post-hoc and exploratory analysis consisting of a subset of patients with mild to moderate upper extremity impairment (baseline JTHFT ≤500).</p><p><strong>Results: </strong>During the 12-week active treatment period, there were no differences between the intervention (n = 18) and control (n = 24) groups in the change in the JTHFT (median -64 vs. -69 seconds, p = .88), the change in the UE-FMA (median 8 vs. 8 points, p = .61), or the total dose of rehabilitation (median 1434 vs. 584 minutes, p = .18). Among the subgroup of patients with mild to moderate symptoms (baseline JTHFT ≤500, n = 31), Smart Glove assignment was associated with a greater improvement on the JTHFT (median -72 vs. -40 seconds, p = .01) and a greater dose of rehabilitation (median 1739 vs. 510 minutes, p = .04) during the active treatment period, but there was no difference in the change in the UE-FMA (median 10 vs. 8 points, p = .15).</p><p><strong>Conclusion: </strong>The addition of the Smart Glove to traditional rehabilitation therapy did not improve hand and arm function in the overall study population but may increase the dose of rehabilitation and improve hand and arm function for patients with mild to moderate upper extremity impairment.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065142","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":"How is wakeful rest operationalized and measured in daily life among adults with and without long-term conditions? A systematic scoping review.","authors":"Martin Ackah, Katie L Hackett, Vincent Deary, Florentina Johanna Hettinga, Hosea Boakye, Ulric Sena Abonie","doi":"10.1002/pmrj.70008","DOIUrl":"https://doi.org/10.1002/pmrj.70008","url":null,"abstract":"<p><p>A systematic scoping review was conducted to examine how rest is operationalized and measured in daily life among adults with and without long-term conditions. Searches were performed in PubMed, Cumulative Index to Nursing and Allied Health Literature, and Psych databases for studies from 1990 to 2024. Two independent reviewers screened and selected eligible studies, which included adults with and without long-term conditions. A content analysis was used to synthesize qualitative and quantitative evidence, categorizing rest-related descriptions. Additionally, descriptive and narrative synthesis methods were employed. Of 9393 initial records, 17 studies were included in the review. The findings revealed that rest was operationalized by several key elements, including cessation of activity or engagement in low-energy tasks (n = 9 studies); detachment from activities (n = 4 studies); experiences of peace, joy, and tranquility (n = 5 studies); and time for self-reflection and solitude (n = 2 studies). The operationalization of rest showed both similarities and differences between adults with and without long-term conditions. Although all groups defined rest in physical, emotional, and social terms, mental rest was more prominently emphasized by adults without long-term conditions. The review also identified the effects of rest, including improvements in well-being and psychological functioning (n = 4 studies) and enhanced energy levels that facilitated daily activities (n = 4 studies). However, \"excessive\" rest was linked to negative outcomes, such as increased physical symptoms and disability (n = 3 studies). Notably, only two studies assessed rest measurement tools for adults with long-term conditions. The findings suggest that rest can enhance energy, well-being, and functioning, but excessive rest may worsen physical symptoms and disability. Tailored guidance on optimal rest is essential for maximizing health benefits. The review also highlights the need for further research on comprehensive tools to measure rest.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001362","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":"Advancements in large language model accuracy for answering physical medicine and rehabilitation board review questions.","authors":"Jason Bitterman, Alexander D'Angelo, Alexandra Holachek, James E Eubanks","doi":"10.1002/pmrj.13386","DOIUrl":"10.1002/pmrj.13386","url":null,"abstract":"<p><strong>Background: </strong>There have been significant advances in machine learning and artificial intelligence technology over the past few years, leading to the release of large language models (LLMs) such as ChatGPT. There are many potential applications for LLMs in health care, but it is critical to first determine how accurate LLMs are before putting them into practice. No studies have evaluated the accuracy and precision of LLMs in responding to questions related to the field of physical medicine and rehabilitation (PM&R).</p><p><strong>Objective: </strong>To determine the accuracy and precision of two OpenAI LLMs (GPT-3.5, released in November 2022, and GPT-4o, released in May 2024) in answering questions related to PM&R knowledge.</p><p><strong>Design: </strong>Cross-sectional study. Both LLMs were tested on the same 744 PM&R knowledge questions that covered all aspects of the field (general rehabilitation, stroke, traumatic brain injury, spinal cord injury, musculoskeletal medicine, pain medicine, electrodiagnostic medicine, pediatric rehabilitation, prosthetics and orthotics, rheumatology, and pharmacology). Each LLM was tested three times on the same question set to assess for precision.</p><p><strong>Setting: </strong>N/A.</p><p><strong>Patients: </strong>N/A.</p><p><strong>Interventions: </strong>N/A.</p><p><strong>Main outcome measure: </strong>Percentage of correctly answered questions.</p><p><strong>Results: </strong>For three runs of the 744-question set, GPT-3.5 answered 56.3%, 56.5%, and 56.9% of the questions correctly. For three runs of the same question set, GPT-4o answered 83.6%, 84%, and 84.1% of the questions correctly. GPT-4o outperformed GPT-3.5 in all subcategories of PM&R questions.</p><p><strong>Conclusions: </strong>LLM technology is rapidly advancing, with the more recent GPT-4o model performing much better on PM&R knowledge questions compared to GPT-3.5. There is potential for LLMs in augmenting clinical practice, medical training, and patient education. However, the technology has limitations and physicians should remain cautious in using it in practice at this time.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1091-1096"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008745","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":"Comparison of baseline PROMIS-10 scores of mental and physical health of patients with low back pain evaluated by physiatrists and orthopedic spine surgeons.","authors":"Rachel Rothman, Glolabo Sokunbi, G Ross Malik, Ellen Casey, Jonathan Kirschner, Carlo Milani, Harvinder Sandhu, Jennifer Cheng, Heidi Prather","doi":"10.1002/pmrj.13378","DOIUrl":"10.1002/pmrj.13378","url":null,"abstract":"<p><strong>Background: </strong>Enabling spine patients to access appropriate spine providers based on their course of care can enhance care outcomes. Physiatrists are trained to provide care throughout the continuum of low-back pain (LBP) symptoms and structural conditions that do not require urgent/emergent spine structural intervention.</p><p><strong>Objective: </strong>To assess if patients triaged to a physiatrist for LBP based on where they are in their continuum of spine care will report better baseline physical and mental health than patients presenting to a spine surgeon.</p><p><strong>Design: </strong>Retrospective study comparing physical and mental health (Patient-Reported Outcomes Measurement Information System [PROMIS]-10) in patients with LBP who are triaged for initial evaluations with physiatrists or spine surgeons.</p><p><strong>Setting: </strong>Tertiary orthopedic hospital.</p><p><strong>Patients: </strong>Adult patients presenting with chief concerns of nonemergent/nonurgent LBP to physiatry or spine surgery from April 1, 2019 to July 1, 2021.</p><p><strong>Interventions: </strong>N/A.</p><p><strong>Main outcome measures: </strong>Initial-visit PROMIS-10 mental and physical health scores.</p><p><strong>Results: </strong>A total of 2646 new patients presented to physiatrists (n = 1911 [72.2%]) and spine surgeons (n = 735 [27.8%]). Patients evaluated by physiatrists had higher mental health (physiatry 50.1 ± 8.5, spine surgery 46.7 ± 9.0; p < .001) and physical health scores (physiatry 43.7 ± 7.5, spine surgery 39.8 ± 7.2; p < .001) than those presenting to spine surgeons. Furthermore, patients evaluated by physiatrists were more likely to have mental and physical health scores >55 and less likely to have scores <45 (p ≤ .001). Patients with LBP + lower extremity (LE) pain had significantly lower mental and physical health scores than those with LBP alone (mental health 48.5 ± 8.6 [LBP + LE-pain], 49.9 ± 8.9 [LBP-alone]; physical health 41.5 ± 7.3 [LBP + LE-pain], 44.0 ± 7.7 [LBP-alone]; p < .001).</p><p><strong>Conclusions: </strong>Patients directed to spine surgeons via triage had worse PROMIS-10 mental and physical health, suggesting this subgroup of patients may especially need additional resources to address these issues in the course of their care. Physiatrists provided nearly two-thirds of nonurgent LBP evaluations in this tertiary orthopedic center, serving an important role in the initial evaluation and treatment of nonurgent LBP. The impact on patient outcomes, patient satisfaction, and associated health care costs requires further investigation.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1069-1079"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008974","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":"Comparative efficacy of platelet rich plasma, hyaluronic acid, and corticosteroid injections in adhesive capsulitis management: A meta-analysis.","authors":"Robert Valencia, Gowtham Anche, Vivian Cao, Dexter Chen, Vince Song, Akash Dontamsetty, Mikhail Volokitin","doi":"10.1002/pmrj.13376","DOIUrl":"10.1002/pmrj.13376","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy of platelet-rich plasma (PRP) and hyaluronic acid (HA) against corticosteroid injections in adult patients with adhesive capsulitis (AC), in impacting pain relief and range of motion (ROM).</p><p><strong>Literature survey: </strong>A systematic review was conducted between January and February 2024 through PubMed and Google Scholar using the following keywords: \"PRP,\" \"Hyaluronic Acid,\" \"Bone Marrow Aspirate,\" \"Frozen Shoulder,\" \"Periarthritis,\" \"Adhesive Capsulitis,\" and \"Corticosteroid Injections.\" Inclusion criteria were studies published between January 2019 and February 2024 and used corticosteroids as a comparison for orthobiologic treatment. The initial search yielded 47 studies, refined to 21 after applying eligibility criteria. Ultimately, six studies were selected.</p><p><strong>Methodology: </strong>Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed, a Cochrane Risk of Bias analysis was performed, and data were independently extracted by multiple authors. A meta-analysis was conducted to compare the efficacy of PRP and HA against corticosteroids measured by visual analog scale (VAS), Shoulder Pain and Disability Index (SPADI), Disabilities of the Arm, Shoulder, and Hand (DASH), and UCLA Shoulder scores.</p><p><strong>Synthesis: </strong>Qualitatively, studies with 3 months or longer patient follow-ups demonstrated better long-term efficacy in pain reduction and ROM improvement with PRP or HA injections. A 6-month improvement in pain as measured by VAS had a significant standardized mean difference (SMD) of -1.31 (95% confidence interval [CI], -1.56 to 1.04). There were significant improvements in functional outcomes at 6 months in DASH (SMD of -1.23 [95% CI, -1.71 to -0.74]) and UCLA Shoulder scores (SMD of 0.74 [95% CI, 0.47-1.00]): No significant differences were observed in 3-month outcomes: DASH (SMD of -0.12 [95% CI, -0.54 to 0.30]) and SPADI scores (SMD of -0.34 [95% CI, -0.78 to 0.10]). Cochrane analysis identified one study with high risk of bias.</p><p><strong>Conclusions: </strong>The review highlights orthobiologics as a promising alternative to corticosteroid injections in managing AC, with PRP providing more long-term pain relief compared to corticosteroid injections. Improvements in shoulder ROM were also seen but require further studies to determine their significance. However, substantial heterogeneity (I² > 50) was observed, underscoring the need for future research to standardize methodologies and improve consistency.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1097-1106"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050484","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":"Spanish Translated Abstracts.","authors":"","doi":"10.1002/pmrj.70034","DOIUrl":"https://doi.org/10.1002/pmrj.70034","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":"17 9","pages":"1126-1133"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between chronic pain and metabolic syndrome: A scoping review.","authors":"Sebastian Encalada, James W Atchison, Cara C Prideaux, Samer Narouze, Johanna Mosquera-Moscoso, Laura Furtado Pessoa de Mendonca, Alejandro Hallo-Carrasco, Larry Prokop, Christine Hunt","doi":"10.1002/pmrj.13361","DOIUrl":"10.1002/pmrj.13361","url":null,"abstract":"<p><p>Metabolic syndrome (MetS) is a prevalent comorbidity in patients with chronic pain conditions. Emerging evidence suggests that the relationship between MetS and chronic pain is bidirectional. This interplay involves complex mechanisms, including proinflammatory mediators in nociceptive modulation and pain-induced lifestyle changes affecting metabolic function. This scoping review examines the association between MetS and chronic pain. We conducted a scoping review, including 28 studies. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. We included observational studies (cross-sectional, case-control, and cohort studies) from the following databases: Ovid MEDLINE, EMBASE, Cochrane Central, Cochrane Database of Systematic Reviews, and Scopus. We identified studies on migraine (n = 9), spinal pain (n = 8), general chronic pain (n = 4), fibromyalgia syndrome (n = 3), carpal tunnel syndrome (n = 1), osteoarthritis (n = 1), shoulder pain (n = 1), and neuropathic pain (n = 1). Most studies used a cross-sectional design and standard criteria to define MetS, with some exceptions. Individuals with MetS and spinal pain, fibromyalgia, or general chronic pain showed higher pain scores and increased functional limitations. MetS was common in patients with migraine, but its effect on pain severity was inconclusive. The relationship between MetS and other pain conditions requires further investigation to clarify the association and potential mechanisms. MetS is prevalent in patients with chronic pain and is associated with worse pain and functional outcomes. Health care providers should acknowledge the wide spectrum of MetS beyond obesity. This understanding may help identify those at risk for more severe chronic pain.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1107-1119"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634217","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}