{"title":"High incidence of decidualization failure in infertile women.","authors":"Isao Tamura, Yumiko Doi-Tanaka, Akihisa Takasaki, Katsunori Shimamura, Toshihide Yoneda, Hitomi Takasaki, Amon Shiroshita, Taishi Fujimura, Yuichiro Shirafuta, Norihiro Sugino","doi":"10.1002/rmb2.12580","DOIUrl":"10.1002/rmb2.12580","url":null,"abstract":"<p><strong>Purpose: </strong>Decidualization is an important event for embryo implantation and successful pregnancy. Impaired decidualization leads to implantation failure and miscarriage. However, it is unclear how often decidualization failure occurs in infertile women. By analyzing the endometrium at late-secretory phase, we investigated the incidence and pathogenesis of decidualization failure among infertile women.</p><p><strong>Methods: </strong>Endometrial dating was performed on the endometria obtained in the late-secretory phase from 33 infertile women. Endometrial dating of more than 2 days delay was taken as an indication of decidualization failure. The expression of essential transcription factors for decidualization (FOXO1, WT1, and C/EBPβ) was examined by immunohistochemistry.</p><p><strong>Results: </strong>Among 32 cases, 20 cases (62.5%) showed decidualization failure. These patients tended to have a history of more frequent miscarriages than those without decidualization failure. The percentage of cells that immunostained positive for the expression of three transcription factors was significantly lower in the patients with decidualization failure than in those without decidualization failure. Serum progesterone levels measured in the mid- and late-secretory phase were not significantly different between the cases with and without decidualization failure.</p><p><strong>Conclusions: </strong>The incidence of decidualization failure is high in infertile women.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12580"},"PeriodicalIF":2.7,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140958465","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":"Morphokinetic features in human embryos: Analysis by our original high-resolution time-lapse cinematography-Summary of the past two decades.","authors":"Yasuyuki Mio, Keitaro Yumoto, Minako Sugishima, Minori Nakaoka, Toko Shimura, Panagiota Tsounapi","doi":"10.1002/rmb2.12578","DOIUrl":"10.1002/rmb2.12578","url":null,"abstract":"<p><strong>Background: </strong>The pioneering work by Dr. Payne et al. in time-lapse cinematography for observation of the morphokinetic features of human embryos inspired us to develop a new in vitro culture system with high-resolution time-lapse cinematography (hR-TLC) back in 2001.</p><p><strong>Methods: </strong>This in vitro culture system was capable of maintaining stable culture and was constructed on an inverted microscope stage. Embryos were observed and photographed noninvasively for an extended period, up to 7 days. The obtained images were displayed at a speed of 30 frames per second and individually analyzed.</p><p><strong>Results: </strong>Using hR-TLC, human fertilization and subsequent embryonic development were visualized, revealing the time course of phenomena and many unusual dynamics.</p><p><strong>Conclusion: </strong>In this review, we summarize the results of our hR-TLC analysis of early human embryonic development over the past 20 years. In the near future, it is expected that the vast amount of information obtained by hR-TLC will be integrated into the AI system for further analysis and to provide feedback that will have the potential to improve clinical practice. In the era of SDGs and environmental awareness, we should be cautious about the direction in which AI can be utilized to avoid any further harm to the planet.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12578"},"PeriodicalIF":2.7,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11077290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892555","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":"Molecular mechanism of autophagy and apoptosis in endometriosis: Current understanding and future research directions.","authors":"Hiroshi Kobayashi, Shogo Imanaka, Chiharu Yoshimoto, Sho Matsubara, Hiroshi Shigetomi","doi":"10.1002/rmb2.12577","DOIUrl":"https://doi.org/10.1002/rmb2.12577","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a common gynecological condition, with symptoms including pain and infertility. Regurgitated endometrial cells into the peritoneal cavity encounter hypoxia and nutrient starvation. Endometriotic cells have evolved various adaptive mechanisms to survive in this inevitable condition. These adaptations include escape from apoptosis. Autophagy, a self-degradation system, controls apoptosis during stress conditions. However, to date, the mechanisms regulating the interplay between autophagy and apoptosis are still poorly understood. In this review, we summarize the current understanding of the molecular characteristics of autophagy in endometriosis and discuss future therapeutic challenges.</p><p><strong>Methods: </strong>A search of PubMed and Google Scholar databases were used to identify relevant studies for this narrative literature review.</p><p><strong>Results: </strong>Autophagy may be dynamically regulated through various intrinsic (e.g., PI3K/AKT/mTOR signal transduction network) and extrinsic (e.g., hypoxia and iron-mediated oxidative stress) pathways, contributing to the development and progression of endometriosis. Upregulation of mTOR expression suppresses apoptosis via inhibiting the autophagy pathway, whereas hypoxia or excess iron often inhibits apoptosis via promoting autophagy.</p><p><strong>Conclusion: </strong>Endometriotic cells may have acquired antiapoptotic mechanisms through unique intrinsic and extrinsic autophagy pathways to survive in changing environments.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12577"},"PeriodicalIF":3.4,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11031673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870913","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":"Management strategies following implantation failure of euploid embryos.","authors":"Keiji Kuroda","doi":"10.1002/rmb2.12576","DOIUrl":"10.1002/rmb2.12576","url":null,"abstract":"<p><strong>Background: </strong>Euploid blastocyst implantation failure may result from embryonic factors undetectable by preimplantation genetic testing for aneuploidy (PGT-A); however, various nonembryonic factors can also intricately interfere with implantation. This review seeks to clarify evidence-based testing and treatments for implantation failure after euploid embryo transfer.</p><p><strong>Methods: </strong>We conducted a review of the literature on implantation failure after euploid embryo transfer or multiple embryo transfer cycles, which mainly included systematic reviews and meta-analyses.</p><p><strong>Results: </strong>The recommended tests for implantation failure include (1) hysteroscopy, (2) endometrial CD138 immunohistochemistry and bacterial culture, (3) serum 25-hydroxyvitamin D<sub>3</sub>, and (4) thrombophilia screening. Based on diagnostic findings, the following treatments have been recommended: (1) antibiotics for chronic endometritis, (2) vitamin D replacement, (3) lifestyle modification, and (4) low-dose aspirin starting from the postimplantation period for thrombophilia. Moreover, frozen-thawed single euploid blastocyst transfer using assisted hatching and hyaluronan-enriched transfer medium may support embryo implantation.</p><p><strong>Conclusion: </strong>To ensure a successful pregnancy in subsequent embryo transfers, simple, inexpensive, and evidence-based tests and treatments should be selected.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12576"},"PeriodicalIF":2.7,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11000815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870147","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":"Impact of current and previous sperm findings on outcomes of intrauterine insemination.","authors":"Maki Taniguchi, Haruhiko Kanasaki, Aki Oride, Hiroe Okada, Kayo Imamura, Satoru Kyo","doi":"10.1002/rmb2.12574","DOIUrl":"10.1002/rmb2.12574","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the association between semen characteristics and outcomes of intrauterine insemination (IUI).</p><p><strong>Methods: </strong>This retrospective analysis examined 1380 IUI procedures involving 421 couples. The association of clinical pregnancy with pre- and post-wash sperm characteristics was assessed.</p><p><strong>Results: </strong>Pre- and post-wash sperm characteristics did not differ between IUI cycles that resulted in pregnancy and those that did not. When the motility of pre-wash sperm was below the normal range (<42%) established by the World Health Organization (WHO), the pregnancy rate was significantly lower. In the IUI cycles when post-wash sperm motility was below the WHO standard, pregnancy was not achieved. The frequency of improvement in post-wash sperm motility in repeated IUI cycles appeared to correlate with the success of future IUI cycles. At the fourth IUI cycle, pregnancy was not achieved unless the post-wash sperm motility was normal in at least two of three attempts. When post-wash sperm concentration was below the normal range, the woman's age did not affect the IUI outcomes.</p><p><strong>Conclusions: </strong>Sperm motility above the lower limit of the WHO criteria in post-wash semen samples is an important factor in IUI outcomes.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12574"},"PeriodicalIF":2.7,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11000811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864241","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":"Identification of long noncoding RNAs downregulated specifically in ovarian high-grade serous carcinoma.","authors":"Maki Hayashi-Okada, Shun Sato, Kengo Nakashima, Takahiro Sakai, Tetsuro Tamehisa, Takuya Kajimura, Isao Tamura, Kotaro Sueoka, Norihiro Sugino","doi":"10.1002/rmb2.12572","DOIUrl":"10.1002/rmb2.12572","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether long noncoding RNAs (lncRNAs) are involved in the development or malignant behavior of ovarian high-grade serous carcinoma (HGSC), we attempted to identify lncRNAs specific to HGSC.</p><p><strong>Methods: </strong>Total RNAs were isolated from HGSC, normal ovarian, and fallopian tube tissue samples and were subjected to a PCR array that can analyze 84 cancer-associated lncRNAs. The lncRNAs that were upregulated and downregulated in HGSC in comparison to multiple samples of normal ovary and fallopian tube were validated by real-time RT-PCR. To infer the function, ovarian cancer cell lines that overexpress the identified lncRNAs were established, and the activation of cell proliferation, migration, and invasion was analyzed.</p><p><strong>Results: </strong>Eleven lncRNAs (ACTA2-AS1, ADAMTS9-AS2, CBR3-AS1, HAND2-AS1, IPW, LINC00312, LINC00887, MEG3, NBR2, TSIX, and XIST) were downregulated in HGSC samples. We established the cell lines that overexpress ADAMTS9-AS2, CBR3-AS1, or NBR2. In cell lines overexpressing ADAMTS9-AS2, cell proliferation was suppressed, but migration and invasion were promoted. In cell lines overexpressing CBR3-AS1 or NBR2, cell migration tended to be promoted, although cell proliferation and invasion were unchanged.</p><p><strong>Conclusion: </strong>We identified eleven lncRNAs that were specifically downregulated in HGSC. Of these, CBR3-AS1, NBR2, and ADAMTS9-AS2 had unique functions in the malignant behaviors of HGSC.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12572"},"PeriodicalIF":4.6,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10988898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860632","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":"Molecular crosstalk between insulin-like growth factors and follicle-stimulating hormone in the regulation of granulosa cell function.","authors":"Emily Hayes, Nicola Winston, Carlos Stocco","doi":"10.1002/rmb2.12575","DOIUrl":"10.1002/rmb2.12575","url":null,"abstract":"<p><strong>Background: </strong>The last phase of folliculogenesis is driven by follicle-stimulating hormone (FSH) and locally produced insulin-like growth factors (IGFs), both essential for forming preovulatory follicles.</p><p><strong>Methods: </strong>This review discusses the molecular crosstalk of the FSH and IGF signaling pathways in regulating follicular granulosa cells (GCs) during the antral-to-preovulatory phase.</p><p><strong>Main findings: </strong>IGFs were considered co-gonadotropins since they amplify FSH actions in GCs. However, this view is not compatible with data showing that FSH requires IGFs to stimulate GCs, that FSH renders GCs sensitive to IGFs, and that FSH signaling interacts with factors downstream of AKT to stimulate GCs. New evidence suggests that FSH and IGF signaling pathways intersect at several levels to regulate gene expression and GC function.</p><p><strong>Conclusion: </strong>FSH and locally produced IGFs form a positive feedback loop essential for preovulatory follicle formation in all species. Understanding the mechanisms by which FSH and IGFs interact to control GC function will help design new interventions to optimize follicle maturation, perfect treatment of ovulatory defects, improve in vitro fertilization, and develop new contraceptive approaches.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12575"},"PeriodicalIF":4.6,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10988955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860265","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}
Kota Fujimoto, Daiki Hashimoto, Sang Woon Kim, Yong Seung Lee, Takuya Suzuki, Masanori Nakata, Shinji Kumegawa, Shinichi Asamura, Gen Yamada
{"title":"Novel erectile analyses revealed augmentable penile Lyve-1, the lymphatic marker, expression.","authors":"Kota Fujimoto, Daiki Hashimoto, Sang Woon Kim, Yong Seung Lee, Takuya Suzuki, Masanori Nakata, Shinji Kumegawa, Shinichi Asamura, Gen Yamada","doi":"10.1002/rmb2.12570","DOIUrl":"10.1002/rmb2.12570","url":null,"abstract":"<p><strong>Purpose: </strong>The pathophysiology of penis extends to erectile dysfunction (ED) to conditions including sexually transmitted diseases (STDs) and cancer. To date, there has been little research evaluating vascular drainage from the penis. We aimed to evaluate penile blood flow in vivo and analyze its possible relationship with the lymphatic maker.</p><p><strong>Materials and methods: </strong>We established an in vivo system designed to assess the dynamic blood outflow from the corpus cavernosum (CC) by dye injection. To analyze lymphatic characteristics in the CC, the expression of Lyve-1, the key lymphatic endothelium marker, was examined by the in vitro system and lipopolysaccharide (LPS) injection to mimic the inflammatory conditions.</p><p><strong>Results: </strong>A novel cavernography methods enable high-resolution morphological and functional blood drainage analysis. The expression of Lyve-1 was detected along the sinusoids. Furthermore, its prominent expression was also observed after penile LPS injection and in the erectile condition.</p><p><strong>Conclusions: </strong>The current in vivo system will potentially contribute to the assessment of penile pathology from a novel viewpoint. In addition, current analyses revealed inducible Lyve-1 expression for LPS injection and the erection state, which requires further analyses on penile lymphatic system.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12570"},"PeriodicalIF":2.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10985380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852625","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}
Jiaqun Li, Juan Liu, Yanye Zhang, Hong Qiu, Junyan Zheng, Jinglei Xue, Jiani Jin, Feida Ni, Chunxi Zhang, Chuan Chen, Xiao Sun, Huiquan Wang, Dan Zhang
{"title":"Effects of paternal ionizing radiation exposure on fertility and offspring's health.","authors":"Jiaqun Li, Juan Liu, Yanye Zhang, Hong Qiu, Junyan Zheng, Jinglei Xue, Jiani Jin, Feida Ni, Chunxi Zhang, Chuan Chen, Xiao Sun, Huiquan Wang, Dan Zhang","doi":"10.1002/rmb2.12567","DOIUrl":"10.1002/rmb2.12567","url":null,"abstract":"<p><strong>Purpose: </strong>The intergenerational effects of ionizing radiation remain controversial. Extensive insights have been revealed for DNA mutations and cancer incidence in progeny, yet many of these results were obtained by immediate post-radiation mating. However, conception at short times after radiation exposure is likely to be avoided. After a long period of fertility recovery, whether unexposed sperm derived from exposed spermatogonia would challenge the health of the offspring is not yet clearly demonstrated.</p><p><strong>Methods: </strong>Ten-week-old C57BL/6J males underwent whole-body acute γ irradiation at 0 and 6.4 Gy. Testes and sperm were collected at different times after radiation to examine reproductive changes. The reproductive, metabolic, and neurodevelopmental parameters were measured in the offspring of controls and the offspring derived from irradiated undifferentiated spermatogonia.</p><p><strong>Results: </strong>Paternal fertility was lost after acute 6.4 Gy γ radiation and recovered at 10-11 weeks post irradiation in mice. The reproductive, metabolic, and neurodevelopmental health of offspring born to irradiated undifferentiated spermatogonia were comparable to those of controls.</p><p><strong>Conclusion: </strong>The male mice could have healthy offspring after recovery from the damage caused by ionizing radiation.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12567"},"PeriodicalIF":2.7,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10961711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140288861","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}
Shinnosuke Komiya, Jun Watanabe, Takero Terayama, Kyosuke Kamijo, Hidetaka Okada
{"title":"Efficacy and safety of follitropin delta versus follitropin alpha/beta in infertility treatment: A systematic review and meta-analysis.","authors":"Shinnosuke Komiya, Jun Watanabe, Takero Terayama, Kyosuke Kamijo, Hidetaka Okada","doi":"10.1002/rmb2.12573","DOIUrl":"10.1002/rmb2.12573","url":null,"abstract":"<p><strong>Background: </strong>Follitropin δ may be an alternative to conventional follitropin α/β for controlled ovarian stimulation (COS) within assisted reproductive treatment (ART), but its efficacy and safety remain unknown. We performed a random-effects meta-analysis to compare the efficacy and safety of follitropin δ and follitropin α/β.</p><p><strong>Methods: </strong>We searched randomized controlled trials comparing follitropin δ and follitropin α/β using MEDLINE, Embase, CENTRAL, ClinicalTrials.gov, and WHO-ITCRP on December 14, 2022. The primary outcomes were the live birth rate and the incidence of moderate or severe ovarian hyperstimulation syndrome (OHSS). The certainty of the evidence was assessed using the grading of recommendations assessment, development, and evaluation approach. The protocol was registered on the Open Science Framework.</p><p><strong>Results: </strong>Three studies involving 2682 participants were included in our meta-analysis. The results indicated that follitropin δ may result in little to no difference in live birth rates (risk ratio [RR], 1.12; 95% confidence interval [CI], 0.91-1.38; low certainty) and the incidence of moderate or severe OHSS (RR, 0.78; 95% CI, 0.48-1.26; low certainty) compared with follitropin α/β.</p><p><strong>Conclusion: </strong>Follitropin δ may result in little to no difference in COS compared with follitropin α/β, especially in terms of live births and safety.</p>","PeriodicalId":21116,"journal":{"name":"Reproductive Medicine and Biology","volume":"23 1","pages":"e12573"},"PeriodicalIF":2.7,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10961712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140288862","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}