Respiratory medicine最新文献

{"title":"Anemia in COPD and cardiovascular mortality","authors":"Ana Ibarra-Macia, Eduardo Garcia-Pachon","doi":"10.1016/j.rmed.2025.108084","DOIUrl":"10.1016/j.rmed.2025.108084","url":null,"abstract":"","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108084"},"PeriodicalIF":3.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768596","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":"The role of arterial stiffness as assessed by the cardio-ankle vascular index in patients with chronic obstructive pulmonary disease","authors":"Kyohei Oishi ,&nbsp;Hideki Yasui ,&nbsp;Yusuke Inoue ,&nbsp;Hironao Hozumi ,&nbsp;Yuzo Suzuki ,&nbsp;Masato Karayama ,&nbsp;Kazuki Furuhashi ,&nbsp;Noriyuki Enomoto ,&nbsp;Tomoyuki Fujisawa ,&nbsp;Naoki Inui ,&nbsp;Takafumi Suda","doi":"10.1016/j.rmed.2025.108078","DOIUrl":"10.1016/j.rmed.2025.108078","url":null,"abstract":"<div><h3>Background</h3><div>Arteriosclerosis and cardiovascular disease (CVD) can greatly affect the progression of chronic obstructive pulmonary disease (COPD). However, standardized methods for evaluating arteriosclerosis in COPD have not been established. The cardio-ankle vascular index (CAVI) is a reliable marker of arterial stiffness and a potential marker for assessing arteriosclerosis. This study aimed to examine the associations between the CAVI and clinical parameters and to evaluate its predictive value for clinical outcomes in COPD.</div></div><div><h3>Methods</h3><div>This retrospective, observational study included patients with COPD who underwent CAVI assessment. The relationships between CAVI and clinical parameters were analysed. The patients were stratified into two groups according to the median CAVI. We examined whether an elevated CAVI was associated with clinical outcomes and evaluated its predictive value for poor clinical outcomes, including disability (modified Rankin Scale score ≥4) or death.</div></div><div><h3>Results</h3><div>A total of 102 patients were analysed (median age: 74 years; 94.1 % men). The median CAVI was 9.4. The CAVI was positively correlated with the percentage of a low attenuation area on computed tomography and negatively correlated with FEV₁ and body mass index, independent of age and the smoking index. An elevated CAVI (&gt;9.4) was associated with severe exacerbations and poor clinical outcomes. A multivariate analysis identified the CAVI as an independent predictor of poor clinical outcomes, regardless of age, severity of dyspnoea, and airflow obstruction.</div></div><div><h3>Conclusion</h3><div>Arterial stiffness assessed by the CAVI is a useful marker of COPD severity and may serve as a prognostic indicator and therapeutic target for improving COPD management.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108078"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143776575","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":"BEAT-CF (Bayesian Evidence Adaptive Treatment for people with Cystic Fibrosis): description of a prospective cohort for nested studies in cystic fibrosis.","authors":"Parveen Fathima, Edward Pan, Julie Marsh, Nelly Newall, Tracey Meares, Charlie McLeod, Shivanthan Shanthikumar, Adam Jaffe, Andrew Tai, Nathan Ward, Sheila Sivam, Hiran Selvadurai, André Schultz, Tom Snelling","doi":"10.1016/j.rmed.2025.108080","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.108080","url":null,"abstract":"<p><strong>Background: </strong>Despite recent improvements in treatment modalities for cystic fibrosis (CF), there is currently limited evidence and a lack of consensus regarding optimal treatment strategies for the different aspects of CF, including pulmonary exacerbations (PEx). We aimed to establish a prospective cohort of people with CF (pwCF) to evaluate alternative approaches to managing CF in the era of modulator therapies.</p><p><strong>Methods: </strong>We prospectively enrolled children and adults with CF receiving care at specialist CF centres across Australia. Participant data were systematically collected on demography, clinical signs and symptoms, comorbidities, spirometry, participant reported outcomes, microbiology and treatments received. Here we describe the demographic, microbiological and clinical characteristics of the participants at enrolment, to understand the representativeness of the cohort for planning future nested studies.</p><p><strong>Results: </strong>Between 14 October 2020 and 31 December 2023, 927 pwCF were enrolled across eleven Australian CF centres. Of these, 51% (n=472) were male, 77% (n=709) were <18 years old, 88% (n=811) had a highest ppFEV1 (percent predicted forced expiratory volume exhaled in the first second) of ≥70% in the preceding year, and 35% (n=322) reported detection of Pseudomonas aeruginosa in their airway specimens.</p><p><strong>Conclusions: </strong>We have established a contemporary cohort of pwCF with granular clinical and treatment data for PEx. This cohort will enable future nested studies focused on PEx management and other aspects of CF care. Understanding the baseline characteristics of these participants, as presented here, is critical for interpreting subsequent outcomes and for identifying factors that may influence disease progression and response to therapies.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108080"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781144","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":"Association between depression, anxiety and long-term healthcare resource utilization in patients with pulmonary embolism","authors":"Inge Kirchberger ,&nbsp;Simone Fischer ,&nbsp;Thomas M. Berghaus ,&nbsp;Jakob Linseisen ,&nbsp;Christine Meisinger","doi":"10.1016/j.rmed.2025.108079","DOIUrl":"10.1016/j.rmed.2025.108079","url":null,"abstract":"<div><h3>Background</h3><div>To date, the utilization of healthcare resources for complications associated with acute pulmonary embolism (PE) have received no attention. This study aimed to explore healthcare utilization and its association with depression and anxiety up to 2 years after in-patient treatment for PE.</div></div><div><h3>Methods</h3><div>Data from the German ‘Lungenembolie Augsburg (LEA)' cohort study was used. Baseline characteristics of the adult patients with PE were collected through an interview during hospital stay and via chart review. Participants completed postal questionnaires 3, 6, 12, and 24 months after their PE event containing questions on healthcare utilization. Depression and anxiety were assessed using the Hospital Anxiety and Depression scale (HADS-D). Negative binomial mixed models were used to investigate the associations between depression and anxiety scores (exposures) and the number of hospitalizations, hospital outpatient clinic visits, general practitioner consultations and medical specialist visits with outcomes adjusted for potential confounders.</div></div><div><h3>Results</h3><div>Out of 569 patients (55 % male, mean age 63.0 ± 14.5 years), 18.3 % had at least mild symptoms of depression and 21.3 % had at least mild symptoms of anxiety at the initial hospitalization. During the first 3 months after hospital discharge, 28.1 % of the patients had at least one hospital readmission. Higher HADS-D depression scores were significantly associated with more hospitalizations (p = 0.0063), hospital outpatient clinic visits (p = 0.0009) and visits to general practitioners (p = 0.0434). Higher HADS-D anxiety scores were significantly associated with more hospitalizations (p = 0.0413) and visits to medical experts (p = 0.0268).</div></div><div><h3>Conclusions</h3><div>Depression and anxiety were significantly associated with increased healthcare utilization in patients with PE.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108079"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768595","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":"Age-related changes of inflammatory cytokines in nasal secretion of patients with chronic rhinosinusitis","authors":"Fang Chen ,&nbsp;Chaosheng Yu ,&nbsp;Tao Zhang ,&nbsp;Congxiang Shen ,&nbsp;Yonghe Li ,&nbsp;Hongzheng Zhang","doi":"10.1016/j.rmed.2025.108082","DOIUrl":"10.1016/j.rmed.2025.108082","url":null,"abstract":"<div><h3>Background</h3><div>Patient-specific factors are highly involved in chronic rhinosinusitis (CRS) 's course and treatment response. However, the effects of aging on the pathophysiology of CRS remain unclear. This study aimed to evaluate the age-related changes in nasal secretion inflammatory characteristics in patients with CRS.</div></div><div><h3>Methods</h3><div>The levels of 12 inflammatory cytokines in nasal mucus samples obtained from 31 patients diagnosed with CRS were measured via enzyme-linked immunosorbent assays. The associations between age and inflammatory cytokine levels were determined by Spearman correlation coefficient analysis. In addition, the relationships between inflammatory markers and demographic evaluation variables such as the Sino-Nasal Outcome Test-22 (SNOT-22) score and disease duration were examined to determine whether the levels of inflammatory cytokines influence the assessment of disease severity in CRS patients.</div></div><div><h3>Results</h3><div>Compared to younger patients with CRS, aged CRS patients exhibited a significant reduction in IL-6 levels (p &lt; 0.01), while levels of IL-10 (p &lt; 0.01), IL-13 (p &lt; 0.01), and Eotaxin (p &lt; 0.05) were markedly elevated. Notably, the Eotaxin level demonstrated a significant decline with age among CRS patients younger than 60 years old (r = −0.79, p &lt; 0.001). Furthermore, the increased mucus TNF-α level was significantly correlated with the prolongation of the disease course in aged CRS patients, with a clinically relevant difference of 7.78 months (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>We have revealed age-specific changes in the inflammatory characteristics of CRS patients, providing new and interesting findings for the development of personalized treatment methods tailored to this high-risk population.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108082"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768594","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":"Corrigendum to \"Evaluation of the benefits of respirator breathing and vomiting training and dynamic core training on improving respiratory muscle strength\" [Respir. Med. 240 (2025) 108029].","authors":"Ran He, Lin Ren","doi":"10.1016/j.rmed.2025.108060","DOIUrl":"10.1016/j.rmed.2025.108060","url":null,"abstract":"","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108060"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773181","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":"Genetically Determined α-Klotho Levels and Causal Association with Aging-Related Lung Diseases.","authors":"Chen Jin, Yuwen Li","doi":"10.1016/j.rmed.2025.108081","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.108081","url":null,"abstract":"<p><strong>Background: </strong>Abnormal α-Klotho (KL) levels play an essential role in the pathogenesis of aging-related lung diseases. However, the correlation between circulating KL levels and aging-related lung diseases has not been determined. This study aimed to determine whether circulating KL levels causally affect aging-related lung diseases using Mendelian randomization (MR).</p><p><strong>Methods: </strong>Five KL-associated Single-nucleotide polymorphisms (SNPs) were analyzed using two-sample MR to assess their effects on three aging-related lung diseases: idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD), and lung cancer.</p><p><strong>Results: </strong>Based on a main casual effects model with MR analyses by the inverse variance weighted (IVW) method including multiplicative random-effects model (IVW-mre) and fixed-effects inverse variance-weighted model (IVW-fe), genetically predicted circulating KL levels were negatively related with risk of IPF (Odds ratio (OR_IVW-mre), 0.999, 95% CI, 0.999-1.000, P_IVW-mre = 0.008; OR _IVW-fe, 0.999, 95% CI, 0.999-1.000, P_IVW-fe = 0.042). Inversely, the circulating levels of KL displayed no clear association with COPD and lung cancer. No pleiotropy was detected.</p><p><strong>Conclusions: </strong>Genetically predicted circulating KL was causally associated with a lower risk of IPF, suggesting a protective effect in preventing IPF risk. Therefore, KL may be a promising target for the prevention and therapeutic intervention in patients with IPF.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108081"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781146","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":"Associations of small airway dysfunction assessed by impulse oscillometry with lung function decline and exacerbations in participants with Chronic Obstructive Pulmonary Disease: a prospective cohort study in China.","authors":"Lifei Lu, Fan Wu, Gaoying Tang, Qi Wan, Zhishan Deng, Jieqi Peng, Cuiqiong Dai, Kunning Zhou, Xiaohui Wu, Shuqing Yu, Yongqing Huang, Changli Yang, Shengtang Chen, Pixin Ran, Yumin Zhou","doi":"10.1016/j.rmed.2025.108075","DOIUrl":"https://doi.org/10.1016/j.rmed.2025.108075","url":null,"abstract":"<p><strong>Introduction: </strong>Small airway dysfunction (SAD) assessed by impulse oscillometry (IOS) was common in patients with chronic obstructive pulmonary disease (COPD). However, little is known about the associations between IOS-defined small airway dysfunction (SAD) and the long-term prognosis of COPD. This study aimed to explore the associations between IOS-defined SAD, lung function decline and exacerbations in patients with COPD.</p><p><strong>Methods: </strong>We analyzed baseline and 2-year follow-up data from the prospective cohort study in China. We defined SAD using IOS parameters Z-score greater than the 1.645 or less than -1.645. Subsequently, these patients were divided into three groups based on the different criteria defined SAD using IOS (normal group [none IOS parameters abnormalities], inconsistent SAD [any IOS parameters abnormalities, but not all], consistent SAD [all of IOS parameters abnormalities]). Negative binomial regression was conducted to analyze the associations between SAD and exacerbations, while a multivariable linear regression model was utilized to identify associations between SAD and lung function decline.</p><p><strong>Results: </strong>833 patients with COPD were enrolled in our study. SAD (defined by X5, AX, and Fres z-score) was associated with a faster decline in lung function and higher risk of exacerbation. Meanwhile, For inconsistent diagnosis of SAD, we observed that patients with consistent SAD and inconsistent SAD experienced a faster decline in FEV₁ and higher risk of exacerbations than those with normal group.</p><p><strong>Conclusions: </strong>IOS-defined SAD was associated with worse outcomes in patients with COPD, and Early intervention in small airway genesis may be effective in slowing the progression of COPD.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry, ChiCTR1900024643. Registered on 19 July 2019.</p>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":" ","pages":"108075"},"PeriodicalIF":3.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773157","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":"Efficacy of Indacaterol vs Tiotropium in COPD patients due to biomass exposure in improving quality of life and reducing symptoms","authors":"Robinson E. Robles-Hernández ,&nbsp;Francisco Montiel-Lopez ,&nbsp;Mónica Velázquez-Uncal ,&nbsp;Raúl H. Sansores ,&nbsp;Rafael J. Hernández-Zenteno ,&nbsp;Rogelio Pérez-Padilla ,&nbsp;Alejandra Ramírez-Venegas","doi":"10.1016/j.rmed.2025.108074","DOIUrl":"10.1016/j.rmed.2025.108074","url":null,"abstract":"<div><h3>Background</h3><div>Few treatment trials have been tested on COPD patients associated with biomass smoke exposure (COPD-B). Patients with COPD-B improve hyperinflation 24 hours after inhaling long-acting beta-agonist (LABA) and long-acting muscarinic antagonist (LAMA), and after six months of treatment, improve symptoms, quality of life, and exacerbations. However, the usefulness of LAMA or LABA for an extended period for improving quality of life and symptoms has not yet been demonstrated in the COPD-B phenotype. The primary aim of this trial was to compare tiotropium (TIO) with indacaterol (IND) in improving the quality of life (QOL) measured by the Saint George's Respiratory Questionnaire (SGRQ) in COPD-B after six months of treatment.</div></div><div><h3>Methods</h3><div>A randomized, open-label, parallel-group clinical trial designed at a third-level health institute in Mexico City. Seventy-three COPD-B women were randomly assigned to either 150 mcg of indacaterol or 18 mcg of tiotropium once daily for 24 weeks.</div></div><div><h3>Results</h3><div>197 patients underwent the screening visit, of which 73 were randomized. There was no significant change in the three domains nor the total score of the SGRQ in either treatment group. For secondary outcomes, the TIO group showed a substantial change in the IC of 160 mL (p=0.016) after six month-treatment. For both treatment groups, a significant reduction in BDI/TDI score of 3 points was shown (p&lt;0.001).</div></div><div><h3>Conclusions</h3><div>Neither TIO nor IND improved quality of life, nor dyspnea evaluated by the mMRC scale, but TIO did improve inspiratory capacity, and TIO and IND improved dyspnea evaluated by BDI/TDI.</div></div><div><h3>Clinical Trial Registration</h3><div>NCT05506865</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108074"},"PeriodicalIF":3.5,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a respiratory therapist-led, community-based asthma program in an under resourced rural border town In California","authors":"Torrie Staten ,&nbsp;Ping-Hui Liu ,&nbsp;Catalina Holt ,&nbsp;Abdullah Alismail","doi":"10.1016/j.rmed.2025.108071","DOIUrl":"10.1016/j.rmed.2025.108071","url":null,"abstract":"<div><h3>Introduction</h3><div>Asthma affects over 300 million people globally, with a higher prevalence in Imperial County, California, due to environmental and social factors. The Asthma Community Linkages Project (ACLP) seeks to reduce emergency visits and enhance asthma self-management through respiratory therapist-led(RT-Led) initiatives. The purpose of this study was to evaluate the effectiveness of using RT-led community-based program in Imperial Country, CA.</div></div><div><h3>Methods</h3><div>Conducted as a quality improvement study, the ACLP is a community-based initiative piloted in Imperial County's local hospitals and rural health clinics through the Asthma Management Program (AMP) and Asthma Wellness Program (AWP) from 2017 to 2020. Participants included 233 patients diagnosed with asthma, identified through ED visits. The program incorporated baseline clinical services, educational modules, and up to three home visits focused on asthma education and trigger mitigation. Data analysis employed paired t-tests and chi-squared tests to assess changes in Asthma Control Test (ACT) scores and ED visit frequency pre-and post-intervention.</div></div><div><h3>Results</h3><div>The study observed significant improvements in asthma control, with ACT scores rising significantly from 15.5 ± 3.03 to 21.33 ± 1.64 (p &lt; 0.001) within six months post-intervention. Notably, completing all three home visits was significantly associated with reduced ED visits at six and twelve months (p &lt; 0.01; p = 0.046). Among the participants, 58.4 % received at least one home visit, underscoring the intervention's reach and impact.</div></div><div><h3>Conclusion</h3><div>The ACLP, a respiratory therapist-led asthma program in Imperial County, California, improved asthma management and reduced emergency department visits. Using an evidence-based practice model and the Plan-Do-Check-Act framework, it addressed environmental and social health determinants through an interdisciplinary approach. The results demonstrated better asthma control in underserved areas, offering valuable insights for similar initiatives in resource-limited settings.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"241 ","pages":"Article 108071"},"PeriodicalIF":3.5,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}