Postgraduate Medical Journal最新文献

{"title":"Advancing chikungunya vaccine equity: a Global Health imperative.","authors":"Amira M Taha, Cameron J Sabet, Dang Nguyen, Alfonso J Rodriguez-Morales","doi":"10.1093/postmj/qgaf036","DOIUrl":"10.1093/postmj/qgaf036","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"931-932"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731359","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":"An insight into a primary care facility in Seelampur slum in Delhi.","authors":"Meghna Shah","doi":"10.1093/postmj/qgaf073","DOIUrl":"10.1093/postmj/qgaf073","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"1081-1083"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120197","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":"Identifying novel risk targets in inflammatory skin diseases by comprehensive proteome-wide Mendelian randomization study.","authors":"Yajia Li, Ziqin Cao, Jianhuang Wu","doi":"10.1093/postmj/qgaf032","DOIUrl":"10.1093/postmj/qgaf032","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in cancer biomarkers and targeted therapies, early diagnosis and treatment of inflammatory skin diseases remain challenging. This study aims to identify circulating proteins causally linked to inflammatory skin diseases, including acne, atopic dermatitis, systemic lupus erythematosus, psoriasis, rosacea, and urticaria, through a Mendelian randomization (MR) framework.</p><p><strong>Methods: </strong>A large-scale MR analysis was performed to assess the causal effects of thousands of plasma proteins on common inflammatory skin diseases. Additional methods, including Steiger filtering, transcriptome-wide association studies, summary data-based MR, protein-protein interaction networks, pathway enrichment analyses, Bayesian colocalization, and drug target evaluation, were employed to validate MR findings and explore therapeutic targets.</p><p><strong>Results: </strong>This study identified >100 circulating proteins that may be involved in inflammatory skin diseases. Tier 1 therapeutic targets include RARRES2, SERPINC1, GALK1, and ECM1 for atopic dermatitis and RARRES2, PPID, and IL1RL1 for acne, rosacea, and urticaria. These proteins represent promising avenues for developing new treatments, with the potential to improve diagnostics and therapeutic strategies in the future.</p><p><strong>Conclusion: </strong>This MR analysis revealed numerous plasma proteins associated with inflammatory skin diseases, offering insights into protein-mediated mechanisms and highlighting promising therapeutic targets for future interventions. Key message What is already known on this topic  Inflammatory skin diseases, including psoriasis, atopic dermatitis, and acne, are complex conditions linked to systemic factors such as alterations in circulating plasma proteins. Previous studies have identified certain proteins involved in skin immune responses; however, a comprehensive understanding of their causal roles remains lacking. What this study adds  This study utilized a large-scale proteome-wide Mendelian randomization analysis to identify >100 circulating proteins causally linked to inflammatory skin diseases. Notably, proteins such as RARRES2, SERPINC1, and ECM1 were highlighted as potential therapeutic targets for atopic dermatitis and acne, among others. How this study might affect research, practice, or policy  The findings provide novel insights into protein-mediated mechanisms underlying inflammatory skin diseases, suggesting new diagnostic and therapeutic avenues. Future research should focus on validating these protein targets in clinical settings and exploring their potential for therapeutic intervention.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"1011-1024"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557805","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 body roundness index and stroke incidence among middle-aged and older adults in China: a longitudinal analysis of the CHARLS data.","authors":"Lanqing Peng, Zhiguo Wen, Cong Xia, Yawei Sun, Yifan Zhang","doi":"10.1093/postmj/qgaf043","DOIUrl":"10.1093/postmj/qgaf043","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between body roundness index (BRI) and stroke risk in middle-aged and elderly Chinese population.</p><p><strong>Methods: </strong>This retrospective cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), including participants aged ≥45 years. BRI was the exposure variable, and stroke incidence was the outcome. Weighted Cox regression models analyzed the association and evaluated the threshold effect of BRI on stroke risk.</p><p><strong>Results: </strong>Among 7651 participants, 519 stroke cases were identified. A one-unit increase in BRI was associated with a 15.8% elevated stroke risk [hazard ratio (HR) = 1.158, 95% confidence interval (CI): 1.158-1.159, P < 0.00001]. Quartile analysis revealed that the highest BRI quartile group had an 80.3% increased stroke risk compared to the lowest quartile (HR = 1.803, 95%CI: 1.800-1.806, P < 0.00001). A threshold effect was observed: when BRI was <5.94, a 1-unit increase was associated with an 18% increased stroke risk (HR = 1.18, 95%CI: 1.08-1.29, P = 0.0002). However, when BRI was >5.94, a 1-unit increase was associated with a non-significant 13% decreased risk (HR = 0.87, 95%CI: 0.68-1.12, P = 0.2944).</p><p><strong>Conclusion: </strong>BRI is significantly and positively associated with stroke risk in middle-aged and elderly Chinese population, with a threshold effect observed. BRI may serve as a valuable marker for stroke prediction and prevention, particularly at lower levels. Further research is needed to investigate BRI's applicability in diverse populations and its potential in developing stroke prevention strategies. Key message What is already known on this topic.  Stroke remains a leading cause of death and disability, particularly in China, emerging body shape indices warrant investigation as cardiovascular predictors, extending beyond the cross-sectional associations documented in previous studies. What this study adds.  In this first longitudinal study of Chinese adults aged 45 and older, we identified four distinct BRI trajectory patterns over a 10-year follow-up, revealing that consistently high and rapidly increasing trajectories were associated with elevated stroke risk, with notable gender differences. How this study might affect research, practice, or policy.  Our findings support BRI trajectory monitoring as a valuable stroke risk assessment tool, emphasizing the importance of gender-specific prevention strategies, stable body shape maintenance, and early intervention for unfavorable patterns.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"1057-1063"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692984","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":"Effects of sarcopenic obesity on incident chronic kidney disease and rapid kidney function decline: evidence from the China health and retirement longitudinal study.","authors":"Mengru Zeng, Linshan Zhou, Xiaojun Chen, Guochun Chen, Li Xiao","doi":"10.1093/postmj/qgaf007","DOIUrl":"10.1093/postmj/qgaf007","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study purpose: &lt;/strong&gt;Evidence on the effects of sarcopenic obesity (SO) on incident chronic kidney disease (CKD) and rapid kidney function decline (RKFD) in the Chinese population is limited. This study aimed to prospectively examine the associations of SO with incident CKD and RKFD among middle-aged and older Chinese adults.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design and methods: &lt;/strong&gt;This prospective cohort study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative longitudinal study of Chinese adults aged 45 and older. The analysis included 4201 individuals from the 2011 wave, with renal outcomes ascertained from the 2015 wave. The effects of SO on incident CKD and RKFD were assessed using logistic regression models. Robustness was tested through subgroup and sensitivity analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Over four years of follow-up, 228 cases of incident CKD and 213 cases of RKFD were observed. After multivariable adjustment, participants in the \"sarcopenic obesity\" group showed a 78% increased risk of incident CKD (odds ratio [OR] 1.78, 95% confidence interval [CI] 1.09-2.90) and a 79% increased risk of RKFD (OR 1.79, 95% CI 1.03-3.13), compared to the \"nonsarcopenia without obesity\" group. Consistent results were observed across subgroups stratified by gender, education level, marital status, geographic area, lifestyle factors, and comorbidities, with no significant interactions detected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In a population-based cohort of middle-aged and older Chinese adults, SO was independently associated with elevated risks of incident CKD and RKFD, without interaction effects. These findings underscore the importance of timely intervention for SO to prevent adverse kidney outcomes. Key message What is already known on this topic?  The relationship between sarcopenic obesity (SO) and the risk of chronic kidney disease (CKD) and renal function decline has been established in Korean and Japanese individuals with type 2 diabetes mellitus. However, it is uncertain if these findings apply to other populations, particularly those without diabetes. Additionally, the influence of diabetes on these associations needs further exploration, and the link between SO and rapid kidney function decline (RKFD) remains unestablished. Evidence regarding the effects of SO on incident CKD and RKFD in the Chinese population is limited, highlighting the necessity for this study to fill these gaps in knowledge. What this study adds  This study is the first to prospectively explore the association of SO with incident CKD and RKFD in middle-aged and older Chinese adults. We identified SO as a significant risk factor for increased incidence of both CKD and RKFD. These findings expand the understanding of the impact of SO beyond individuals with diabetes mellitus, indicating that SO is a universal risk factor for adverse kidney outcomes in aging populations, irrespective of demographic","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"960-966"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010284","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":"Drug selection in the management of acute low back pain and sciatica: consideration of pain characteristics and drug metabolism.","authors":"Chao Zhang, Qian Wu","doi":"10.1093/postmj/qgaf025","DOIUrl":"10.1093/postmj/qgaf025","url":null,"abstract":"","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"1084-1085"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483605","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":"Genetically predicted effects of COVID-19 on 2272 traits: exploring through a phenome-wide Mendelian randomization study.","authors":"Junyu Zhou, Yi Ge, Jing Yu, Yu Zhang","doi":"10.1093/postmj/qgaf037","DOIUrl":"10.1093/postmj/qgaf037","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has significantly impacted global health, making it essential to understand its genetic effects on various traits.</p><p><strong>Method: </strong>Leveraging the extensive FinnGen dataset comprising 500 000 individuals, we performed a Mendelian randomization (MR) phenome-wide association study. COVID-19-related phenotypes obtained from the COVID-19 Host Genetics Initiative GWAS (release 7). We employed four distinct approaches, including MR-Egger, weighted median, random-effect inverse variance weighted (IVW), and weighted mode, to conduct the MR analysis.</p><p><strong>Results: </strong>Two hundred fifty-five potential causal effects of COVID-19 were observed for a diverse range of outcomes using the IVW method, including cardiovascular disorders, respiratory conditions, autoimmune diseases, and metabolic disorders. Apart from a few that can be classified as \"other traits,\" the majority of the traits are disease-related traits. We have also identified 31 traits, wherein all four distinct MR analyses yielded a P-value of less than 0.05. Only one trait remained statistically significant after multiple testing correction using the conservative Bonferroni threshold (P < 2.2E-5).</p><p><strong>Conclusions: </strong>This phenome-wide MR study provides valuable insights into the genetically predicted effects of COVID-19 on a comprehensive range of traits. The identified associations contribute to our understanding of the complex interplay between the impact of the post-COVID-19 era on healthcare and may have implications for the development of targeted therapeutic strategies and public health interventions. Key messages What is already known on this topic - COVID-19 has a high mortality rate, and patients often have many sequelae, including myocarditis, acute respiratory distress syndrome, and neurological and hematologic complications. What this study adds Most of the current relevant studies lack large-scale phenotype-group ranging Mendelian randomization (MR) studies on the outcome of COVID-19 due to their small sample sizes. Therefore, this study performed a full phenotypic group MR analysis in the FinnGen dataset to investigate the relationship between COVID-19 and thousands of outcome variables. How this study might affect research, practice or policy- The study identified a set of traits that are strongly associated with genetic susceptibility to the long-term effects of COVID-19.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"1034-1040"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692989","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":"Effect of non-invasive brain stimulation on cancer-related pain: evidence from meta-analyses of randomized controlled trials.","authors":"Yaqi Zhang, Xiuyun He, Chen Gong, Yafei Wang, Longfei You, Yangyang Lin, Yuling Wang, Beibei Feng","doi":"10.1093/postmj/qgaf027","DOIUrl":"10.1093/postmj/qgaf027","url":null,"abstract":"<p><strong>Purpose: </strong>Cancer-related pain (CRP) is one of the most challenging disorders among cancer survivors. Non-invasive brain stimulation (NIBS) is an emerging technique for alleviating pain. Although there is evidence suggesting that NIBS can alleviate CRP, higher level evidence is still required to further substantiate its efficacy and safety. This study aimed to evaluate the efficacy of NIBS interventions for CRP via a meta-analysis.</p><p><strong>Methods: </strong>Databases such as MEDLINE, PubMed, Embase, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, China National Knowledge Infrastructure were systematically searched using key terms related to pain, cancer, and NIBS. The primary outcome was pain intensity and the secondary outcome was depression. After extracting and assessing data from the included literature, we performed Meta-analysis using RevMan 5.4.1 software.</p><p><strong>Results: </strong>The results encompassed 11 randomized controlled trials papers, involving 714 patients. The Meta-analysis findings indicated that NIBS demonstrated a significant reduction in pain intensity scores {SMD -0.72 [95% confidence interval (CI), -1.00 to -0.43], P < 0.00001}. NIBS also had a notable effect on depression [SMD -0.62 (95% CI, -0.93 to -0.31), P = 0.0004]. However, subgroup analysis revealed that one single session of NIBS did not show statistical significance in analgesic effect. Furthermore, no matter targeting the M1 and DLPFC areas, as well as using either rTMS or tDCS, resulted in significant reductions in pain intensity.</p><p><strong>Conclusion: </strong>NIBS exhibited a promising trend in alleviating CRP and enhancing treatment effectiveness. Nonetheless, due to limitations in the quantity and quality of the included studies, these findings warrant further validation through additional research.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"949-959"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415040","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":"Helmet continuous positive airway pressure as noninvasive ventilation for COVID-19 patients; a systematic review and meta-analysis of randomized trials.","authors":"Yongke Zheng, Shihan Zhou, Nanyuan Gu, Xiaokang Zeng, Hayat Khizar, Longhuan Zeng","doi":"10.1093/postmj/qgaf038","DOIUrl":"10.1093/postmj/qgaf038","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has challenged healthcare systems globally, highlighting the need for effective respiratory support strategies. Helmet continuous positive airway pressure (CPAP) has emerged as a potential noninvasive ventilation (NIV) method for COVID-19 patients.</p><p><strong>Methods: </strong>We searched PubMed, EMBASE, the Cochrane Library, and Scopus from December 1, 2019, to June 1, 2024. Randomized controlled trials (RCTs) comparing helmet CPAP therapy with standard oxygen therapy or other forms of NIV in COVID-19 patients with acute hypoxemic respiratory failure were included. Random effects meta-analyses were performed to calculate pooled risk ratios (RRs) with 95% confidence intervals (95% CIs).</p><p><strong>Results: </strong>Three RCTs involving 580 patients were included in this analysis. There was no significant differences (P > 0.05) in mortality at 28 d (RR, 1.20; 95% CI, 0.84-1.71), 60-90 d (1.02, 95% CI, 0.75-1.37), or 180 d (0.98, 95% CI, 0.76-1.25) between the helmet CPAP group and the control group as well as similar intubation rates (RR 0.90; 95% CI, 0.73-1.10) and times to intubation. However, helmet CPAP was associated with significantly shorter ICU stays and hospital stays. The adverse event rates were similar between the groups. Patient comfort, as measured by the EQ-VAS, was significantly better with the CPAP helmet.</p><p><strong>Conclusion: </strong>The use of helmet CPAP for the treatment of respiratory failure in patients with COVID-19 showed comparable intubation rates and shorter ICU and hospital stays without increasing mortality or adverse events. Key messages What is already known about this topic?  Noninvasive ventilation (NIV) methods, such as helmet CPAP, treat patients with acute hypoxemic respiratory failure. The effectiveness of helmet CPAP for COVID-19 patients is unknown. What this study adds?  This study shows that helmet CPAP has similar intubation and mortality rates to standard treatments in COVID-19 acute respiratory failure patients. It also highlights how helmet CPAP reduces ICU and hospital stays and improves patient comfort. How this study might affect research, practice, or policy?  The findings of this study could lead to future research into helmet CPAP approaches for COVID-19 and other respiratory failure patients. They could also influence clinical practice and healthcare policy by emphasizing helmet CPAP as a preferable noninvasive ventilation technique for similar patient populations.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"1041-1048"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649995","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":"Effects of mindfulness and sleep quality on self-efficacy of clinical decision making among resident physicians: an observational study.","authors":"Mira M Abu-Elenin, Reham M Mounir, Walaa M Shehata","doi":"10.1093/postmj/qgaf031","DOIUrl":"10.1093/postmj/qgaf031","url":null,"abstract":"<p><strong>Background: </strong>Mindfulness and sleep quality implicate the mental well-being of physicians; whose job demands high cognitive performance.</p><p><strong>Aim: </strong>This study aimed to measure the effect of sleep quality and mindfulness on residents to make timely proper clinical decisions.</p><p><strong>Methods: </strong>A cross-section study recruited 200 residents at Tanta University hospitals, in Egypt. Sleep quality was assessed using the Sleep Quality Scale, Mindfulness was measured by the Mindful Attention Awareness Scale, and clinical self-decision efficacy was determined by the Decision Self-efficacy Scale.</p><p><strong>Results: </strong>The study revealed that 22.5% of respondents had poor quality and 46.5% had low decision self-efficacy. A statistically significant high score of mindfulness was observed between residents of non-surgical specialties (3.1 ± 0.7). High capability of clinical decisions efficiently was statistically signficant and proportionally correlated with increased mindfulness scale (r = 0.4, P = 0.002). Lower self-efficacy was significantly associated with taking >3-night shifts/week and reduced break duration.</p><p><strong>Conclusion: </strong>There is remarkable low to moderate self-efficacy for clinical decision-making capability among the studied resident physicians, underpinned by the degree of mindfulness and hospital environmental factors.</p>","PeriodicalId":20374,"journal":{"name":"Postgraduate Medical Journal","volume":" ","pages":"1003-1010"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701355","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}