Scandinavian Journal of Clinical & Laboratory Investigation最新文献

{"title":"Longitudinal assessment of glomerular and tubular kidney function after COVID-19: a prospective cohort study.","authors":"Hanna Jerndal, Jennifer Ödeen, Johan Hultdin, Guilherme W F Barros, Alicia Lind, Clas Ahlm, Mattias Forsell, Sara Cajander, Anne-Marie Fors Connolly, Bernd Stegmayr, Johan Normark, Kristina Stefansson","doi":"10.1080/00365513.2026.2724491","DOIUrl":"10.1080/00365513.2026.2724491","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 is a multi-organ disease affecting the kidneys, but the extent of persistent kidney injury and the utility of novel biomarkers remain unclear. We investigated patients with COVID-19 regarding initial impairment and recovery of glomerular and tubular function during 6 months.</p><p><strong>Methods: </strong>We conducted a prospective cohort study comprising 77 hospitalized and 141 non-hospitalized patients with COVID-19 in Sweden. Plasma samples collected during the acute phase and at 3- and 6-month follow-up were analyzed for glomerular markers creatinine and cystatin C to estimate glomerular filtration rate (eGFR). Tubular markers included kidney injury molecule-1, osteoactivin, trefoil factor 3, and vascular endothelial growth factor-A.</p><p><strong>Results: </strong>Hospitalized versus non-hospitalized patients demonstrated lower eGFR_{cystatin C} across time-points, while eGFR_creatinine was less specific. Kidney injury molecule-1 and vascular endothelial growth factor-A were persistently higher in hospitalized patients. Osteoactivin was lower at the acute phase and higher at 3- and 6 months follow-up in hospitalized patients. Recovery from the acute phase to 6 months was observed in both groups, although the biomarker levels were consistently worse for hospitalized patients.</p><p><strong>Conclusion: </strong>Glomerular and tubular kidney functions remained more impaired in hospitalized COVID-19 patients compared to non-hospitalized for 6 months. We recommend eGFR_{cystatin C} for evaluation of glomerular function during COVID-19. The tubular injury markers kidney injury molecule-1 and vascular endothelial growth factor-A were markedly elevated in hospitalized patients, consistent with more sustained interstitial inflammation. This finding suggests that these patients may require closer clinical monitoring.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"581-592"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888452","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":"Wrongly estimated pretest probability can be harmful.","authors":"Arne Åsberg, Øyvind Skadberg","doi":"10.1080/00365513.2026.2724496","DOIUrl":"10.1080/00365513.2026.2724496","url":null,"abstract":"<p><p>By necessity, a wrongly estimated pretest probability leads to a wrongly estimated posttest probability, even for correctly interpreted quantitative diagnostic test results. The effect of wrongly estimated pretest probability on the clinical utility of quantitative test results is unknown. We simulated test results from one real and two imaginary, quantitative diagnostic tests to study this issue for specific values of benefit and cost of treatment. We found that a wrongly estimated pretest probability reduces the clinical utility of a correctly interpreted quantitative diagnostic test result and may, in extreme cases, cause harm to the patient.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"606-612"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148832081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical impact of 131-iodine whole-body scintigraphy following 131-iodine therapy of thyroid cancer.","authors":"Mira Simone Hofmann, Julie Kjems, Bo Zerahn, Bent Kristensen, Christian Maare, Lars Thorbjørn Jensen","doi":"10.1080/00365513.2026.2738164","DOIUrl":"10.1080/00365513.2026.2738164","url":null,"abstract":"<p><p>The incidence of thyroid cancer has increased globally and in Denmark. Following total thyroidectomy, patients at intermediate or high risk undergo radioactive iodine (RAI) therapy with ¹³¹I to ablate residual thyroid tissue and treat potential metastases. European and American guidelines recommend post-treatment whole-body scintigraphy (WBS) 2-10 days after RAI to supply information on disease staging. This study evaluated whether post-treatment ¹³¹I WBS findings influenced subsequent clinical management for the patients. In this retrospective cohort study, 363 patients received RAI at Herlev University Hospital between January, 2021, and February, 2024. Post-treatment ¹³¹I WBS was available in 330 patients (91% - the study group). In a subgroup analysis, patients with negative scans, known metastases, or prior RAI therapy were excluded. Medical records were reviewed to determine whether WBS findings led to changes in management, defined as additional RAI therapy, supplementary imaging, or modification of follow-up. Among the 330 patients, 249 (76%) high-risk patients received 3.7 GBq, 80 (24%) intermediate-risk patients received 1.1 GBq, and one pediatric patient received 2.0 GBq. No intermediate-risk patients showed iodine-avid foci beyond residual neck uptake. Among the 298 patients who received adjuvant RAI without known metastatic disease, 15 had suspected metastases on WBS, of whom only six (2%) experienced a management change. ost-treatment ¹³¹I WBS rarely influenced decision-making, affecting only 2% of adjuvant RAI patients. Given the overall good prognosis and limited clinical impact, the routine use of post-treatment ¹³¹I WBS, particularly in intermediate-risk patients, may warrant reconsideration in future guidelines.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"694-701"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064433","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":"Thyroid hormones and semen quality in infertile men: a large-scale stratified analysis revealing gradient associations.","authors":"Xiuxiu Lei, Yaoting Xu, Yixin Shao, Bo Zhu, Lejun Li, Shuai Li","doi":"10.1080/00365513.2026.2669916","DOIUrl":"10.1080/00365513.2026.2669916","url":null,"abstract":"<p><p>Thyroid hormones (THs) modulate male reproductive function, but their graded associations with multidimensional semen parameters remain poorly defined. This stratified analysis investigated TH levels and semen quality in 5142 infertile men (20-45 years). Serum concentrations of free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), total thyroxine (TT4) and thyroid-stimulating hormone (TSH) were measured and stratified into quartiles (Q1-Q4). Comprehensive semen analysis included conventional, kinematic and morphological parameters. Multivariable logistic regression was used to assess the risk of specific semen abnormalities. Key findings revealed hormone-specific, graded associations: lower FT3 (Q1-Q2) and TT3 (Q1-Q2) levels were independently associated with increased risk of oligozoospermia (adjusted odds ratios [aORs] ranging from 1.434 to 1.785), while moderate FT3 (Q3) and FT4 (Q3) levels conferred protection against asthenozoospermia (aORs: 0.740 and 0.664, respectively). For teratozoospermia, lower TT3 (Q1) increased risk (aOR: 1.219), whereas moderate FT4 (Q2) was protective (aOR: 0.705). Interestingly, men in the lowest TSH quartile (Q1) exhibited a lower risk of both oligozoospermia and asthenozoospermia. Beyond conventional parameters, FT3 and TT4 demonstrated the most extensive associations with detailed motility, morphology and kinematic measures, including progressive motility, head/tail defects and multiple velocity parameters. These findings suggest that TH levels exhibit graded associations with semen quality in infertile men, with specific strata - even within conventional reference ranges - serving as independent risk factors for distinct semen abnormalities. The observed hormone-specific signatures support the potential integration of comprehensive thyroid profiling into male infertility evaluation, enabling refined risk stratification and personalized clinical management.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"344-354"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147960251","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":"Performance evaluation of an avian antibody-based particle-enhanced turbidimetric assay for free kappa and lambda light chains.","authors":"Johan Olausson, Anna Tagesson, Anders Larsson","doi":"10.1080/00365513.2026.2684028","DOIUrl":"10.1080/00365513.2026.2684028","url":null,"abstract":"<p><p>Quantification of serum free light chains (FLCs) is essential for the diagnosis and monitoring of plasma cell disorders. This study evaluated the analytical performance of a novel avian IgY-based particle-enhanced turbidimetric immunoassay (PETIA) for measuring free kappa (κ) and lambda (λ) light chains in serum and plasma. The assay was evaluated on the Cobas Pro c503 (Roche Diagnostics, Basel, Switzerland) and Abbott Architect c4000 (Abbott Laboratories, Abbott Park, IL) platforms using samples from patients with monoclonal components and healthy donors. Performance characteristics included precision, limit of quantification (LoQ), linearity, interference, measuring interval, reagent stability, high-dose hook effect, method comparison with the Diazyme FLC assay, and reference interval verification in 70 healthy individuals. Within-run precision was acceptable at clinically relevant concentrations. Functional LoQs (15% CV) were 1.94 mg/L for <i>κ</i> and 3.74 mg/L for <i>λ</i>. Linearity was demonstrated on the Abbott platform, with no significant interference from haemolysis, lipaemia or bilirubin. Reagents were stable for 38 days on-board, and no hook effect was observed at very high FLC concentrations. Method comparison showed strong correlation with the Diazyme assay (<i>κ: r</i> = 0.953; <i>λ: r</i> = 0.881) and substantial agreement for <i>κ</i>/<i>λ</i> ratios (Cohen's <i>κ</i> = 0.64). Verified reference intervals aligned with established standards. The IgY-based PETIA provides precise, interference-resistant measurement of free κ and λ light chains across a wide dynamic range, supporting its suitability for routine clinical use.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"426-435"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212228","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 a standardized meal on inflammatory biomarkers.","authors":"Magnus Dencker, Ola Björgell, Joanna Hlebowicz","doi":"10.1080/00365513.2026.2630318","DOIUrl":"10.1080/00365513.2026.2630318","url":null,"abstract":"<p><p>The digestion of food is known to have significant hemodynamic and metabolic effects where many have not been fully investigated. The potential effect of food intake could be interesting both from a physiological point of view and from a methodological point of view, as it could affect when blood samples are collected. The objective of this study was to investigate the effect of food intake on 143 different predominantly inflammatory but also some organ damage biomarkers. Twenty-two healthy subjects (11 male and 11 female aged 25.9 ± 4.2 years) were investigated. A total of 143 biomarkers were measured before a standardized meal as well as 30 and 120 min afterwards with the Proseek Multiplex Inflammation I, and Multiplex Organ Damage panels, both using the Olink's Proximity Extension Assay. The levels for 23 biomarkers were significantly (<i>p</i> < 0.001) changed due to food intake. A total of 14 biomarkers decreased 30 min and 120 min after food intake. Four biomarkers were increased only at 120 min after food intake. The changes for the biomarkers were between 2% and 105%. This study shows that food intake has some effect on 143 different biomarkers. The timing of blood sampling in relation to food intake could be a concern when investigating Interleukin-6, Anterior gradient protein 2 homolog, BH3-interacting domain death agonist, Tyrosine-protein kinase Fes/Fps, Syntaxin-8, Probetacellulin, Peptidyl-prolyl cis-trans isomerase FKBP1B, Ribonucleoside-diphosphate reductase subunit M2 B, and Enteropeptidase, which all changed more than 30%.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"95-109"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195407","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":"Indispensable tools of critical care management: blood gas analyzers.","authors":"Hazar Gözgöz, Tuncay Küme, Ali Necati Gökmen","doi":"10.1080/00365513.2026.2659585","DOIUrl":"10.1080/00365513.2026.2659585","url":null,"abstract":"<p><p>Blood gas analysis remains one of the most indispensable diagnostic tools in critical care, yet increasing automation often obscures its analytical foundations and limitations. This review provides an integrated perspective by tracing the evolution of blood gas testing from the 1952 polio epidemic to contemporary microfluidic biosensor platforms. Core physical principles governing gas behavior are summarized, and the operational mechanisms of potentiometric (pH and pCO₂) and amperometric (pO₂) sensors are explained alongside the essential role of optical co-oximetry in identifying dyshemoglobinemias. Major sources of pre-analytical error-such as leukocyte larceny, heparin dilution effects, and syringe permeability-are critically examined, emphasizing the need for meticulous sample handling and appropriate temperature correction. Acid-base interpretation frameworks, including the Boston, Copenhagen, and Stewart physicochemical approaches, are compared to highlight their respective clinical utilities. While Henderson-Hasselbalch-based methods support rapid bedside decision-making, the Stewart model provides enhanced diagnostic clarity in complex metabolic disturbances. Understanding sensor limitations and pre-analytical vulnerabilities remains as crucial as interpreting the numerical results themselves. Future integration of artificial intelligence-based decision support and emerging in-vivo monitoring technologies may further improve diagnostic accuracy and therapeutic turnaround time in critical care.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"209-223"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699732","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":"Establishing continuous reference intervals for thyroid function tests.","authors":"Funda İpekten, Gökmen Zararsız, Halef Okan Doğan, Çiğdem Karakükçü, Gözde Ertürk Zararsız","doi":"10.1080/00365513.2026.2659594","DOIUrl":"10.1080/00365513.2026.2659594","url":null,"abstract":"<p><p>This study aimed to establish age- and gender-specific reference intervals for thyroid function tests-fT3 (pmol/L), fT4 (pmol/L), and TSH (μIU/L)-in both pediatric and adult populations, and for anti-TPO (kIU/L) only in adults. It also compared partitioned and continuous modeling approaches to determine the most appropriate method for clinical interpretation. In this retrospective observational study, laboratory data from individuals who visited Sivas Cumhuriyet University Hospital between 2017 and 2022 were analyzed. Partitioned reference intervals were determined using the refineR method. Continuous reference intervals were modeled using Generalized Additive Models for Location, Scale, and Shape (GAMLSS), including LMS (Box-Cox Normal), LMST (Box-Cox t), and LMSP (Box-Cox Power Exponential) distributions. Model selection was based on Generalized Akaike Information Criterion (GAIC) values, and gender differences were evaluated using parametric and non-parametric tests.</p><p><p>In pediatric subjects, hormone distributions largely overlapped between sexes during early childhood, whereas significant gender differences in fT3 appeared after approximately age 12 (<i>p</i> < 0.001). In adults, males generally showed higher fT3 concentrations than females, while sex differences in fT4 were less consistent across ages. TSH levels showed minimal gender-related variation in both pediatric and adult groups. According to GAIC values, the LMSP model provided the best fit for thyroid function parameters in both pediatric and adult datasets. Continuous reference interval modeling captured gradual age-related changes and provided a flexible framework for evaluating thyroid function.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"323-333"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842317","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":"Diurnal fluctuations in thyroid hormones - the Bispebjerg study of diurnal variations.","authors":"Bakhtawar Zahra Rabab, Christian Zinck Jensen, Henrik Løvendahl Jørgensen, Henriette Pia Sennels","doi":"10.1080/00365513.2026.2659592","DOIUrl":"10.1080/00365513.2026.2659592","url":null,"abstract":"<p><p>Misinterpretation of diurnal variation in thyroid hormones and thyroid stimulating hormone (TSH) could have a significant impact on diagnostic interpretation. However, the circadian rhythm of plasma thyroxine (T4) and triiodothyronine (T3) is unclarified. The aim of this study was to assess the clinical relevance of diurnal variation in thyroid hormones and TSH.</p><p><p>Blood samples from 24 healthy Caucasian males were drawn every third hour for 24 h in a controlled environment. Diurnal variation of TSH and total/free peripheral thyroid hormones was evaluated by cosinor rhythmometry. Data was fitted with both ordinary least squares regression and mixed-effects models.</p><p><p>Cosinor analysis showed statistically significant diurnal variation of TSH (<i>p</i> < 0.001), which displayed the lowest levels in the early afternoon and peaked at 2 am. During 24 h, the average within subject coefficient of variation of TSH was 31%, whereas for the peripheral thyroid hormones it was between 4-7%. All thyroid parameters exhibited large between-participant differences in individual mesor values. Extending the model to account for these individual differences in biological set-point - a mixed-effects cosinor analysis - all thyroid parameters showed statistically significant diurnal variation (<i>p</i> < 0.001), except free T3 (<i>p</i> = 0.056). Total T3 displayed a diurnal profile almost synchronized with TSH, albeit with a small temporal lag, while free/total T4 oscillated opposite to TSH with a peak around mid-day and nadir at night.</p><p><p>In conclusion, thyroid parameters in this study exhibited significant diurnal variation, particularly TSH. These physiological fluctuations should be considered when diagnosing thyroid diseases.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"298-305"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147779712","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":"Recommendation on quality assurance of pneumatic transportation systems an opinion paper from the Nordic preanalytical scientific working group.","authors":"Jonna Pelanti, Britta Willman, Anna Linko-Parvinen, Mads Nybo","doi":"10.1080/00365513.2026.2659591","DOIUrl":"10.1080/00365513.2026.2659591","url":null,"abstract":"<p><p>Pneumatic transportation systems (PTS) are used for sample transportation to ensure faster turn-around-times. This transportation form can however cause preanalytical changes in the samples, especially haemolysis, and it must therefore be controlled and surveyed. In order to elucidate the use and quality control (QC) of PTS in the Nordic countries, a survey was conducted in 2018 and 2024. A questionnaire was constructed using Webropol based on the CLSI document H18-A4 on handling and processing of blood specimens. It was distributed electronically in 2018 to all Nordic biochemistry laboratories through the National societies of clinical biochemistry. Due to Covid-19, the results were unfortunately not handled timely, and a follow-up questionnaire was therefore distributed in 2024. In 2018, 85 laboratories replied, while 30 laboratories replied in 2024. In 2018, 24% of the transportation lines ended either directly on the analysis track or in a bulk sorter connected to the track, while in 2024, 59% ended directly on the analysis track. In 2018, 69% had validated their PTS, mostly using haemolysis index (32%), while in 2024, 88% had validated their PTS with 87% using haemolysis index. In 2024, only 10% used internal QC for their PTS, while just 24% had entered an external quality assessment program, which was unavailable in 2018. Despite a promising development in PTS validation and quality control, several necessary actions are needed when samples are delivered <i>via</i> PTS. The Nordic preanalytical scientific working group has listed recommendations that should be adopted to ensure sample quality.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"293-297"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699718","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}