Postgraduate Medical Journal最新文献

{"title":"Perceived prevalence, risk factors, and reported management of delirium in critically ill emergency patients: a survey of physicians in China.","authors":"Wen Shang, Kang Zheng, Lanfang Du, Hua Zhang, Rongjia Yang, Fengying Chen, Wencao Liu, Xianliang Yan, Qingbian Ma","doi":"10.1093/postmj/qgaf136","DOIUrl":"https://doi.org/10.1093/postmj/qgaf136","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate Chinese emergency physicians' perceptions of prevalence, associated risk factors, and reported management practices for delirium in critically ill emergency department (ED) patients.</p><p><strong>Methods: </strong>A cross-sectional survey of 402 physicians from EDs across 18 Chinese provinces.</p><p><strong>Results: </strong>Physician-estimated delirium prevalence varied widely (median: 15%; interquartile range: 10%-30%), with most perceiving higher incidence during night shifts. Key perceived risk factors included metabolic disorders, pre-existing cognitive impairment, shock, and severe infections. Clinical judgment was the most common assessment method; structured screening tools were reportedly used infrequently. Pharmacological interventions were the preferred management approach for most respondents.</p><p><strong>Conclusions: </strong>This survey highlights Chinese emergency physicians' varied perceptions of delirium prevalence and reliance on clinical judgment over standardized assessment. Findings suggest a need for enhanced training in standardized screening, greater emphasis on non-pharmacological interventions, and fostering interprofessional collaboration to improve care for ED patients with or at risk of delirium. Key messages What is already known on this topic: Delirium is a serious acute neurocognitive syndrome with high Intensive Care Unit prevalence (31.8%-70%) and significant adverse outcomes. Emergency department delirium remains under recognized despite 6%-38% prevalence in older adults. International guidelines recommend non-pharmacological interventions as first-line management. What this study adds: This survey provides the first assessment of Chinese emergency physicians' delirium perceptions in critically ill patients. Key findings reveal predominant reliance on clinical judgment rather than validated tools and a preference for pharmacological interventions, particularly benzodiazepines, which conflicts with international guidelines. Substantial variation exists in perceived prevalence estimates. How this study might affect research, practice, or policy: Findings inform targeted educational initiatives for Chinese emergency departments, emphasizing the need for standardized screening training and non-pharmacological intervention promotion. Future research should prioritize objective epidemiological studies to validate perceived prevalence rates and evaluate protocol implementation.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144965983","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":"Physician's concerns and patient's concerns: never the twain shall meet?","authors":"Ami Schattner","doi":"10.1093/postmj/qgaf134","DOIUrl":"https://doi.org/10.1093/postmj/qgaf134","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966021","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":"Risk factors of severe adverse in-hospital outcomes in adults hospitalized for parainfluenza infections: a territory-wide study.","authors":"Wang Chun Kwok, Kelvin Kai Wang To, Isaac Sze Him Leung, Chun Ka Wong, James Chung Man Ho, David Chi Leung Lam, Mary Sau Man Ip, Shuk Man Ngai, Desmond Yat Hin Yap","doi":"10.1093/postmj/qgaf127","DOIUrl":"https://doi.org/10.1093/postmj/qgaf127","url":null,"abstract":"<p><strong>Background: </strong>While parainfluenza virus infections are common, there is relatively little data on the impact and risk factors of parainfluenza virus infection on severe in-hospital outcomes.</p><p><strong>Methods: </strong>This territory-wide retrospective study elucidated the risk factors for serious in-hospital outcomes among patients hospitalized due to parainfluenza infection. Data were retrieved from the Clinical Data Analysis and Reporting System managed by the Hospital Authority, Hong Kong, from 1 January 2016 to 30 June 2023. The main outcomes of interest were: (i) death during hospitalization; (ii) severe respiratory failure requiring invasive or non-invasive mechanical ventilation; (iii) secondary bacterial pneumonia; (iv) acute kidney injury.</p><p><strong>Results: </strong>2058 adult patients were hospitalized due to parainfluenza virus infection during the study period. 87 (4.2%) patients died during the index admission, 467 (22.7%) patients developed severe respiratory failure, 1355 (65.8%) patients developed secondary bacterial pneumonia, and 625 (30.3%) patients developed acute kidney injury. Risk factors for severe in-hospital outcomes included underlying cardiopulmonary and kidney diseases (especially those receiving renal replacement therapy) and advanced age.</p><p><strong>Conclusions: </strong>Important risk factors for severe in-hospital outcomes among patients with parainfluenza infections include underlying age ≥65 years, cardio-pulmonary and kidney diseases. These at-risk patients may benefit from future vaccines and antiviral drugs. Key messages What is already known on this topic: Severe in-hospital outcomes among adult patients with parainfluenza infections are common What this study adds: The risk factors for severe in-hospital outcomes include underlying age ≥ 65 years, cardio-pulmonary, and kidney diseases How this study might affect research, practice, or policy: These at-risk patients may benefit from future vaccines and antiviral drugs.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966062","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":"Potential circadian rhythm-related pathogenic genes in coronary artery disease: a Mendelian randomization study.","authors":"Hongliang Zhang, Zhenyan Zhao, Wence Shi, Guannan Niu, Dejing Feng, Moyang Wang, Zheng Zhou, Zhe Li, Jie Zhao, Yongjian Wu","doi":"10.1093/postmj/qgaf125","DOIUrl":"https://doi.org/10.1093/postmj/qgaf125","url":null,"abstract":"<p><strong>Purpose: </strong>Coronary artery disease (CAD) is a leading cause of cardiovascular morbidity and mortality worldwide. Recent studies suggest disruptions in circadian rhythms may contribute to CAD, but the underlying mechanisms remain unclear. This study employs summary-data-based Mendelian randomization to explore the roles of circadian rhythm genes in CAD and their clinical implications.</p><p><strong>Methods: </strong>We retrieved circadian rhythm-related genes from the GeneCards database and utilized genome-wide association study summary data for CAD from the IEU database, further validated with FinnGen and UK Biobank datasets. We integrated expression quantitative trait loci (eQTL), methylation quantitative trait loci (mQTL), and protein abundance quantitative trait loci (pQTL) data to assess causal associations with CAD. Colocalization analysis confirmed that the signals originated from the same genetic variants.</p><p><strong>Results: </strong>Our analyses identified 49 mQTLs, 11 eQTLs, and one pQTL causally associated with CAD. Integration of mQTL and eQTL data revealed 13 methylation sites and eight key genes, particularly RASD1 (OR = 0.777, 95% CI: 0.672-0.898) and SREBF1 (OR = 0.893, 95% CI: 0.844-0.946). The DNA methylation level at site cg20122488 was negatively correlated with RASD1 expression, while eQTL data for SREBF1 indicated a regulatory relationship with CAD risk.</p><p><strong>Conclusions: </strong>This study emphasizes the significant roles of circadian rhythm genes RASD1 and SREBF1 in CAD pathogenesis. Findings suggest therapeutic potential for these genes, warranting further research to validate their functions and inform preventive and treatment strategies. Key messages What is already known Coronary artery disease (CAD) is a leading global cause of cardiovascular mortality, with circadian rhythm disruptions increasingly implicated in its pathogenesis, though causal genetic mechanisms remain unclear. What this study adds This Mendelian randomization study identifies 13 methylation sites and eight key circadian-related genes (e.g. RASD1, SREBF1) with causal links to CAD, revealing specific epigenetic and transcriptional regulatory effects on disease risk. How this study might affect research, practice, or policy The findings highlight circadian rhythm genes as potential therapeutic targets, offering novel insights for CAD prevention strategies and guiding future research into circadian-based interventions.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966093","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":"Of evidence, eminence, and other influences: a light-hearted look at real-world surgical decision-making.","authors":"Dhananjaya Sharma","doi":"10.1093/postmj/qgaf135","DOIUrl":"10.1093/postmj/qgaf135","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874847","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":"Efficacy and safety of non-focused low-intensity ultrasound technology for subcutaneous lipolysis in the lower abdomen: a clinical study.","authors":"Jieying Tang, Lujia Chen, Shihong Zhang, Hui Shao, Lu Wang, Chuan Wang, Qiang Chen, Yikang Hou, Xueyin Liao, Meina Song, Cuicui Zhang, Xuemei Zhang, Jianmin Yang, Weiwei Li","doi":"10.1093/postmj/qgaf008","DOIUrl":"10.1093/postmj/qgaf008","url":null,"abstract":"<p><strong>Background: </strong>With rising demand for non-invasive body contouring, this study aimed to evaluate the efficacy and safety of non-focused, low-intensity ultrasound for lower abdominal lipolysis.</p><p><strong>Methods: </strong>The enrolled subjects prospectively received 6 weekly sessions of well-setting ultrasound treatment with frequency of 1 MHz and an intensity of 2.2 W/cm2, to target the subcutaneous fat of lower abdomen with three regions (left, middle, and right). Evaluations included ultrasound measurements and blood biochemical analyses at the baseline, pre-4th session, and at 1 and 2-month post-treatment points to confirm the efficacy and safety.</p><p><strong>Results: </strong>A total of 17 subjects completed the whole treatment. Significant reductions in superficial abdominal fat layer thickness of all three regions were observed (all P-values of ANOVA <0.001), without severe adverse events reported. Post-hoc analysis showed the superficial fat layers of all the three regions at 1-month post-treatment significant reductions comparing the baseline (all adjusted P < 0.05). The reduction effects for superficial fat layers were still available at the 2-month post-treatment follow-up at the left and middle regions. Conversely, there was no significant improvements among the deep fat layers at the three regions.</p><p><strong>Conclusion: </strong>Non-focused, low-intensity ultrasound demonstrate its potential of efficacy and safety for reducing superficial abdominal fat, and may maintain the capability for at least two months. Further studies are needed to confirm long-term efficacy and optimize treatment parameters.   What is already known on this topic? Non-focused ultrasound with low-intensity is recognized for its potential in non-invasive body contouring, but detailed efficacy and safety data were limited, especially for lower abdominal lipolysis. What this study adds? Our research demonstrated the efficacy and safety of non-focused ultrasound with low-intensity in reducing superficial abdominal fat, with sustained effects for at least two months. How this study might affect research, practice, or policy? This study could guide future researches toward long-term effects and optimization of ultrasound treatments, and influence clinical practice by providing a validated method for non-invasive fat reduction.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"814-819"},"PeriodicalIF":2.7,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010289","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":"Association between sleep duration and depression in adolescents and young adults: a system review of observational studies and a genetic research of Mendelian randomization analysis.","authors":"Qiu-Qiang Zheng, Wei-Wei Yang, Shan-Shu He, Yi-Ran Li","doi":"10.1093/postmj/qgaf013","DOIUrl":"10.1093/postmj/qgaf013","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore the causal association between sleep duration and depression in adolescents and young adults.</p><p><strong>Methods: </strong>We conducted a systematic review and Mendelian randomization (MR) to research the causal relationship between short sleep duration and adolescent depression risk from an observational and genetic perspective. In the systematic review, we searched observational studies from the PubMed, Embase, and Cochrane Library databases. In the MR analysis part, we screened Single Nucleotide Polymorphism (SNP) significantly relative to short sleep and conforming MR concept to investigate the genetic causality.</p><p><strong>Results: </strong>All research evidence shows that adolescents who sleep <6 h have the highest rates of depression. According to the MR result, short sleep duration significantly affected the depression risk (odds ratio, 1.034; 95% confidence interval, 1.012-1.058, P = .003). Sleep duration of 7-8 h has the lowest depression incidence. Insufficient sleep (≤6 h) and excessive sleep (≥8 h) also elevates adolescent depression risk. Genetic evidence shows that short sleep duration (<6 h) has significant causal effects on depression risk.</p><p><strong>Conclusions: </strong>Sleep duration was causally associated with depression in adolescents and young adults. Sleep duration of <6 h or >8 h daily increases the depression risk in adolescents and young adults.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"845-853"},"PeriodicalIF":2.7,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190279","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":"A new strategy for drug delivery systems in oral diseases using stem cell-derived extracellular vesicles: review and new perspectives.","authors":"Ruyang Xia, Maojiao Li, Bo Huang","doi":"10.1093/postmj/qgae187","DOIUrl":"10.1093/postmj/qgae187","url":null,"abstract":"<p><p>Extracellular vesicles (EVs) are membrane vesicles derived from cells and serve as an endogenous mechanism for intercellular communication. Since the discovery of their capacity to effectively transfer biological information, their potential as drug delivery vehicles has garnered significant scientific interest. Particularly, EVs derived from mesenchymal cells (MSC-EVs) have emerged as a highly promising method for drug delivery. They can transport bioactive molecules, such as nucleic acids, lipids, and proteins, and possess the ability to modulate immune responses, transmit information, and target specific cells. EVs offer several advantages over conventional drug delivery systems, including their capacity to traverse natural barriers, inherent cell targeting capabilities, and stability in circulation. Compared to their parent cells, EVs exhibit low immunogenicity, ease of storage and transport, and a reduced risk of tumorigenesis. The diagnosis and treatment of oral diseases often involve invasive measures, and MSC-EVs have demonstrated initial efficacy in oral disease treatment. This review explores the application of MSC-EVs in maxillofacial tissue regeneration, periodontitis, temporomandibular joint osteoarthritis, Sjögren's Syndrome, oral cancer, and other oral diseases. Additionally, it outlines potential future directions for the development of MSC-EVs. This review aims to provide a comprehensive understanding of MSC-EVs in oral disease treatment and to stimulate interest in their applications for targeted drug delivery.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"779-790"},"PeriodicalIF":2.7,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896938","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":"Measures to prevent esophageal stenosis are necessary after endoscopic submucosal dissection for early esophageal cancer lesions with a circumferential ratio of 75%-99%: a retrospective case analysis.","authors":"Yong Gao, Jiao Zhu, Jianjun Li, Xue Peng, Xubiao Nie, Haiyan Zhao, Lifu Sheng, Chaoqiang Fan, Jianying Bai","doi":"10.1093/postmj/qgaf005","DOIUrl":"10.1093/postmj/qgaf005","url":null,"abstract":"<p><strong>Purpose: </strong>Endoscopic submucosal dissection (ESD) is currently one of the most curative treatments for early esophageal cancer. We conducted a retrospective case analysis to identify the characteristics of early esophageal cancer that indicate esophageal stenosis prevention measures. Our aim was to provide a reference for clinical decision-making.</p><p><strong>Methods: </strong>Six hundred and fifty-four patients with early esophageal cancer treated with ESD were admitted to our hospital between January 2011 and December 2018.Clinical information such as patients' demographic characteristics, lesion features, preventive measures if any, and complications of esophageal stenosis after ESD were collected from the hospital information system. The data were statistically analysed by SPSS software (version 23.0).</p><p><strong>Results: </strong>1. Seventy-nine patients with early esophageal cancer suffered from esophageal stenosis after ESD. The median time from undergoing ESD to the first occurrence of stenosis was 27 (17-43) days. Specifically, among the 79 cases, 47 of them experienced stenosis within one month after ESD, and 23 cases experienced stenosis between 1 and 2 months after ESD, and 9 cases experienced stenosis more than 2 months after the operation.2. Taking preventive measures significantly reduced overall esophageal stenosis incidence in patients with early esophageal cancer with lesion circumferential ratio of 75%-99% (P < 0.05).3. Among patients with early esophageal cancer with 75%-99% circumferential proportion of lesions, the risk of esophageal stenosis within 2 months without prevention measures was 2.617(95% CI, 1.057-6.479) times higher than that with prevention measures.</p><p><strong>Conclusion: </strong>It is necessary to take measures to prevent esophageal stenosis after ESD for early esophageal cancer lesions with a circumferential ratio of 75%-99%.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"820-827"},"PeriodicalIF":2.7,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029434","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":"Association of fibrinogen-to-albumin ratio with all-cause and cardiovascular mortality in patients on dialysis with acute coronary syndrome.","authors":"Enmin Xie, Yaxin Wu, Zixiang Ye, Xuecheng Zhao, Yike Li, Nan Shen, FanFan Wang, Yanxiang Gao, Jingang Zheng","doi":"10.1093/postmj/qgaf015","DOIUrl":"10.1093/postmj/qgaf015","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the association of the fibrinogen-to-albumin ratio (FAR) and all-cause mortality as well as cardiovascular mortality in patients on dialysis with acute coronary syndrome (ACS). Furthermore, we explored the incremental prognostic value of incorporating the FAR into the Global Registry of Acute Coronary Events (GRACE) score.</p><p><strong>Methods: </strong>We retrospectively enrolled 1035 patients on dialysis with ACS between January 2015 and June 2021. The primary outcome was all-cause mortality, and the secondary outcome was cardiovascular mortality. Multivariate Cox regression model, restricted cubic spline analysis, and C-statistic were performed to evaluate the prognostic value of FAR on outcomes.</p><p><strong>Results: </strong>After a median follow-up of 21.8 months, 369 (35.7%) patients died, including 250 cardiovascular deaths. Patients with the highest FAR tertile had significantly increased risks of all-cause mortality (46.1% vs 27.8%; adjusted hazard ratio [HR], 1.790; 95% confidence interval [CI], 1.372-2.336) and cardiovascular mortality (33.0% vs 16.5%; adjusted HR, 2.086; 95% CI, 1.496-2.908) compared to those in the lowest tertile. Restricted cubic spline analysis revealed a J-shaped association between the FAR and all-cause mortality and cardiovascular mortality, with HRs increasing significantly when the FAR exceeded 94.15. Furthermore, integrating the FAR into the GRACE score significantly improved its predictive accuracy for all-cause mortality and cardiovascular mortality, as measured by C-statistic, continuous net reclassification index, and integrated discriminatory index.</p><p><strong>Conclusions: </strong>In patients on dialysis with ACS, the FAR was independently associated with increased risks of all-cause mortality and cardiovascular mortality. Incorporating the FAR might improve the predictive accuracy of the GRACE score in patients on dialysis with ACS.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"915-924"},"PeriodicalIF":2.7,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374661","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}