Sleep medicine最新文献

{"title":"Unraveling the pathophysiology of restless legs syndrome from multimodal MRI techniques: A systematic review","authors":"Tapas Pani ,&nbsp;Maria Paola Mogavero ,&nbsp;Raffaele Ferri ,&nbsp;Giuseppe Lanza","doi":"10.1016/j.sleep.2024.11.020","DOIUrl":"10.1016/j.sleep.2024.11.020","url":null,"abstract":"<div><h3>Background</h3><div>Restless Legs Syndrome (RLS) is a common neurological disorder currently diagnosed based on clinical features only, and characterized by a compulsive urge to move the legs triggered by rest or diminished arousal. This systematic review aimed at integrating all current brain magnetic resonance imaging (MRI) modalities for a convergent pathophysiological understanding of RLS phenomenology.</div></div><div><h3>Methods</h3><div>We performed a MEDLINE (PubMed)-based systematic review for research articles in patients with primary RLS published in English from 2010 till November 2023. Studies meeting the inclusion criteria according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria were systematically assessed for quality using modality-specific checklists, bias using AXIS tool and a narrative synthesis of the results was conducted.</div></div><div><h3>Results</h3><div>A total of 49 studies (22 structural, 12 DTI, 7 iron-imaging, 4 spectroscopy with 10 datasets combining multiple approaches) involving 1273 patients (414 males) and 1333 healthy controls (478 males) met the eligibility criteria. Despite participant, technical/device-related and statistical heterogeneity, most agree that patients with primary RLS have structural and metabolite alterations, changes in multiple white matter tract architectures, and disrupted <span><span>functional connectivity</span><svg><path></path></svg></span> within multiple brain areas. Most of the studies (n = 43, 88 %) have a low-risk of bias on the AXIS scale. Scores on the modality-specific checklist ranged from 46 to 92 %, 70–93 % and 54–92 % for structural MRI, DTI and MRS Datasets, respectively.</div></div><div><h3>Conclusions</h3><div>Notwithstanding the large heterogeneity in the methods employed, global connectivity alterations suggest the utility of casting RLS within a system-level perspective rather than viewing it as related to the dysfunction of a single or particular brain region. A holistic approach and its integration within the framework of molecular vulnerability and neurotransmitter alterations are warranted to disentangle the complex pathophysiology of RLS and to identify new therapeutic targets.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"125 ","pages":"Pages 31-56"},"PeriodicalIF":3.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Kairos positive airway pressure (KPAP) equals continuous PAP in effectiveness, and offers superior comfort for obstructive sleep apnea treatment” [Sleep Med 124 (2024) 268–275/6239]","authors":"David P. White ,&nbsp;Ludovico Messineo ,&nbsp;Evelyn Thompson ,&nbsp;Bryan Hughes ,&nbsp;Wilson D. Lannom ,&nbsp;Bernard Hete ,&nbsp;Abinash Joshi ,&nbsp;William H. Noah","doi":"10.1016/j.sleep.2024.11.019","DOIUrl":"10.1016/j.sleep.2024.11.019","url":null,"abstract":"","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Page 703"},"PeriodicalIF":3.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of sleep disturbance among Chinese healthcare professionals increases Eastward—caution with position in time zone","authors":"José María Martín-Olalla,&nbsp;Jorge Mira","doi":"10.1016/j.sleep.2024.11.021","DOIUrl":"10.1016/j.sleep.2024.11.021","url":null,"abstract":"<div><div>We analyze data of the prevalence of sleep disturbance among Chinese healthcare professionals and maintain that they increase Eastward, refining previous results. We suggest that position in time zone is a valid explanatory metric only after daily rhythms have been uniformed. On a more general note, this finding suggest that daylight saving time might help reduce sleep disturbance.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"125 ","pages":"Pages 87-88"},"PeriodicalIF":3.8,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Optiflow™ interface for chronic CPAP in infants","authors":"Sonia Khirani ,&nbsp;Plamen Bokov ,&nbsp;Marine Dosso ,&nbsp;Lucie Griffon ,&nbsp;Clément Poirault ,&nbsp;Benjamin Dudoignon ,&nbsp;Brigitte Fauroux","doi":"10.1016/j.sleep.2024.11.014","DOIUrl":"10.1016/j.sleep.2024.11.014","url":null,"abstract":"<div><div>Continuous positive airway pressure (CPAP) is increasingly used in infants. However, the limited number of commercially masks available for infants is challenging. The use of the Optiflow™ nasal cannula (Fisher &amp; Paykel) with a regular CPAP device has been recently reported for chronic CPAP in children, with an objective improvement in polysomnographic events. However, this interface has not been used in young infants. We report here our experience of 4 infants aged between 3 and 8 weeks, who were treated with home CPAP with the Optiflow™ nasal cannula during a few months, before they could be successfully weaned. This pilot study reinforces the findings of the beneficial use of this nasal cannula in very young infants in whom nasal masks are scarce and not always suitably adapted. However, as this interface is not intended to be used with home CPAP, further studies are necessary to prove its clinical benefice and safety of use with home CPAP devices.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"125 ","pages":"Pages 14-17"},"PeriodicalIF":3.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resting-state functional connectome predicts sleep quality two months after the first negative COVID-19 antigen test","authors":"Shuyu Jin ,&nbsp;Haobo Chen ,&nbsp;Ling Li ,&nbsp;Yi Liu ,&nbsp;Peng Liu ,&nbsp;An Xie ,&nbsp;Yanhui Liao","doi":"10.1016/j.sleep.2024.11.012","DOIUrl":"10.1016/j.sleep.2024.11.012","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic has led to long-term neurological and psychological effects, including sleep disturbances. While prior studies have identified altered brain function post-COVID-19, specific functional connectivity (FC) patterns predicting sleep quality after recovery remain unclear. This study aims to identify FC patterns associated with sleep quality two months after the first negative COVID-19 antigen test.</div></div><div><h3>Methods</h3><div>Using a connectome-based predictive modeling (CPM) approach, we identified the functional connectome regulating sleep quality based on a 164-region parcellation. Significant connections were analyzed using mediation models to examine their role in the relationship between anxiety, depression, and sleep.</div></div><div><h3>Results</h3><div>FC between the right cerebellar peduncle and the left VIII of the cerebellum, and between the left middle temporal pole (MTP) and left ventral tegmental area (VTA), significantly predicted Pittsburgh Sleep Quality Index (PSQI) scores for sleep disturbances two months post-recovery (q² = 0.059, MSE = 0.154, p = 0.017, r = 0.350). Mediation analysis showed a significant indirect effect of FC between the left MTP and VTA on the relationship between generalized anxiety and sleep disturbances (indirect effect = 0.013, 95% CI = [0.002, 0.03], pfdr &lt;0.05). FC between the right dorsal raphe nucleus and ipsilateral regions—including occipital, parietal, and temporal areas—predicted PSQI scores for daytime dysfunction (q² = 0.092, MSE = 0.678, p = 0.025, r = 0.342).</div></div><div><h3>Conclusion</h3><div>Post-COVID-19 brain connectivity and anxiety predict sleep quality. These findings highlight the potential for targeted therapeutic strategies to improve sleep and identify patients at risk for prolonged disturbances through FC biomarkers.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 727-736"},"PeriodicalIF":3.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why NIV setting definitions may be tricky: Trigger sensitivity","authors":"Sonia Khirani ,&nbsp;Lucie Griffon ,&nbsp;Anais Le ,&nbsp;Domenico Paolo La Regina ,&nbsp;Marine Dosso ,&nbsp;Clément Poirault ,&nbsp;Brigitte Fauroux","doi":"10.1016/j.sleep.2024.11.015","DOIUrl":"10.1016/j.sleep.2024.11.015","url":null,"abstract":"<div><div>Noninvasive ventilation (NIV) is widely used in children. The spontaneous/timed (S/T) mode is the most common used mode for home NIV. Different devices are available, and the manufacturers are free to name the modes and define the settings, with no regulation. In particular, the definitions of the trigger sensitivities still differ between manufacturers and/or devices. The inspiratory trigger (TgI) sensitivity may be set according to a numerical or word-rating scale, while the expiratory trigger (TgE) sensitivity may be set as a percentage of the peak inspiratory flow, or using a numerical or word rating scale which correspond to specific predefined percentages of inspiratory flow. Moreover, the TgE sensitivity may be set according to the peak inspiratory flow or to the diminution of peak inspiratory flow, which may be very confusing. Patient-ventilator asynchrony (PVA) may be due to an inadequate comprehension of the settings by the user, which is challenging. We report here the cases of four children and adolescents with an incorrect setting of the TgI and/or TgE, leading to PVA. This pleads for a harmonization of the definitions of the settings, and in particular of the trigger sensitivities. In the meanwhile, NIV professionals should be aware of the different definitions to avoid setting errors leading to PVA.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"125 ","pages":"Pages 18-20"},"PeriodicalIF":3.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social support and isolation in narcolepsy and idiopathic hypersomnia: An international survey","authors":"Julie Flygare ,&nbsp;Lauren Oglesby ,&nbsp;Sairam Parthasarathy ,&nbsp;Michael J. Thorpy ,&nbsp;Emmanuel Mignot ,&nbsp;Eileen B. Leary ,&nbsp;Anne Marie Morse","doi":"10.1016/j.sleep.2024.11.013","DOIUrl":"10.1016/j.sleep.2024.11.013","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate factors associated with feeling supported in adjusting to life when diagnosed with narcolepsy or idiopathic hypersomnia.</div></div><div><h3>Methods</h3><div>An online survey was disseminated by nonprofit organization Project Sleep via email and social networks. Intended recipients were adults (≥18 years old) diagnosed with narcolepsy or idiopathic hypersomnia. Multivariable regression was used to assess predictors of feeling supported in adjusting to life with these conditions.</div></div><div><h3>Results</h3><div>The survey was completed by 1308 individuals (narcolepsy type 1, 48.4 %; narcolepsy type 2, 28.7 %; idiopathic hypersomnia, 22.9 %). Overall, 68.7 % of respondents were ≤40 years of age; 87.7 % were female; and 88.8 % were White. Respondents lived in 38 different countries (65.5 % in the United States). At time of diagnosis, most (91.1 %) did not know anyone with the same diagnosis. At time of the survey, 486 respondents (37.2 %) still did not know anyone with their diagnosis. Only 32.3 % of respondents felt supported in adjusting to life with narcolepsy or idiopathic hypersomnia. Knowing someone with the same diagnosis at the time of the survey was a significant predictor of perceived support. Younger age (18–30 years) and being married were also associated with greater perceived support, whereas a diagnosis of narcolepsy type 2 or idiopathic hypersomnia (versus narcolepsy type 1) and living outside the US were associated with less perceived support.</div></div><div><h3>Conclusions</h3><div>People with narcolepsy or idiopathic hypersomnia often do not know others living with the same condition, even though this is associated with feeling supported. Clinicians should assess for social support and assist with resource identification.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"125 ","pages":"Pages 65-73"},"PeriodicalIF":3.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of exercise on sleep quality in general population: Meta-analysis and systematic review","authors":"Xiaojie Zhou ,&nbsp;Yan Kong ,&nbsp;Beibei Yu ,&nbsp;Shengnan Shi ,&nbsp;Hui He","doi":"10.1016/j.sleep.2024.10.036","DOIUrl":"10.1016/j.sleep.2024.10.036","url":null,"abstract":"<div><h3>Purpose</h3><div>Sleep is the foundation of human physiological health and psychological health, as well as one of the basic needs for human survival. Sleep quality problems are prevalent in the population, and poor sleep quality is often closely related to the occurrence of many diseases, which seriously affects the quality of life and may even result in a shortened lifespan, so that improving sleep health has become a real problem that needs to be solved urgently. Exercise, as an important non-pharmacological tool, has been widely used for sleep quality enhancement, while the efficacy of exercise on subjective and objective sleep with respect to individual sleep quality remains controversial. Therefore, the aim of this meta-analysis was to compare the effects of exercise on subjective sleep quality and objective sleep efficiency in a non-athlete population, and to further rank the effectiveness of exercise types to provide appropriate means of exercise to improve sleep.</div></div><div><h3>Methods</h3><div>This study was evaluated by literature search in five databases, PubMed, Embase, Web of Science, Cochrane, and EBSCO, and paired meta-analysis and network meta-analysis were performed using Review Manager 5.3 and stata16.0.</div></div><div><h3>Results</h3><div>A total of 7494 studies were retrieved, and 81 eligible randomized controlled trials involving 6193 subjects were finally included. The primary outcome metrics included subjective sleep quality (PSQI), and the secondary outcome was objective sleep efficiency (SE), of which 65 reported PSQI and 23 reported SE. The results of paired meta-analysis showed that exercise significantly decreased PSQI [MD = −1.77, (95 % CI = −2.28,-1.25),P &lt; 0.05] and increased SE [MD = 4.81, (95 % CI = 2.89,6.73),P &lt; 0.05]. The results of the network meta-analysis showed that body and mind exercise [MD = −2.28, (95 % CI = −3.19,-1.36),P &lt; 0.05, SUCRA = 85.6] may be the best exercise to improve PSQI, and aerobic exercise [MD = 5.02, (95 % CI = 2.52,7.52),P &lt; 0.05, SUCRA = 75.1] is most likely to be the best type of exercise to improve SE. In regression analyses, there was a moderating effect of exercise cycle (β = −0.25 [0.40, 0.46], SE = 0.10 [P = 0.015, R² = 0.24]) and age (β = −0.20 [-0.04, −0.01, SE = −2.06 [P = 0.039,R² = 0.16]) as moderators of objective sleep efficiency.</div></div><div><h3>Conclusion</h3><div>Exercise is effective in improving both subjective and objective sleep quality. Body and mind exercise, aerobic exercise, and aerobic combined with resistance exercise may be the preferred way to improve sleep, and the longer the exercise cycle, the more obvious the improvement in sleep effect, the improvement effect will gradually decrease with age.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"125 ","pages":"Pages 1-13"},"PeriodicalIF":3.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142658613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep risk factors modify the association between c-reactive protein and type 2 diabetes: A prospective cohort study","authors":"Mengying Wang ,&nbsp;Huangda Guo ,&nbsp;Hexiang Peng ,&nbsp;Siyue Wang ,&nbsp;Xueheng Wang ,&nbsp;Meng Fan ,&nbsp;Jin Jiang ,&nbsp;Tianjiao Hou ,&nbsp;Chenghua Gao ,&nbsp;Wenyan Xian ,&nbsp;Jie Huang ,&nbsp;Tao Wu","doi":"10.1016/j.sleep.2024.11.001","DOIUrl":"10.1016/j.sleep.2024.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the prospective association between serum CRP levels and T2D incidence and explore whether such association was modified by sleep risk factors.</div></div><div><h3>Methods</h3><div>The study included 366 746 participants without diabetes and exhibited CRP measures at baseline from the UK Biobank. Sleep risk factors included sleep duration, insomnia, snoring, chronotype, and daytime sleepiness. Cox proportional hazards model was used to estimate the hazard ratio (HR), and 95 % confidence interval (CI) of T2D associated with CRP levels. Interactions between CRP and sleep risk factors were also tested.</div></div><div><h3>Results</h3><div>During a median follow-up of 10.4 years, 14 200 T2D cases were identified. The HRs (95 % CIs) of T2D were 1.31 (1.21–1.43), 1.62 (1.50–1.75), 1.98 (1.83–2.13), and 2.38 (2.21–2.57), respectively, in higher quintile groups of CRP levels compared with the lowest group (p-value for trend &lt;0.001). There were interactions of CRP levels with self-reported sleep duration, snoring, and daytime sleepiness (p-value for interaction = 0.002, 0.0002, and 0.0001). The associated risks between T2D and the elevation in CRP were more evident among participants with high-risk sleep factors.</div></div><div><h3>Conclusions</h3><div>Our study indicates that the elevation in serum CRP levels is associated with a higher T2D incidence; and such relation is modified by sleep risk factors including sleep duration, snoring, and daytime sleepiness.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 674-680"},"PeriodicalIF":3.8,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"mCLAS adaptively rescues disease-specific sleep and wake phenotypes in neurodegeneration","authors":"Inês Dias ,&nbsp;Christian R. Baumann ,&nbsp;Daniela Noain","doi":"10.1016/j.sleep.2024.11.009","DOIUrl":"10.1016/j.sleep.2024.11.009","url":null,"abstract":"<div><div>Sleep alterations are hallmarks of prodromal Alzheimer's (AD) and Parkinson's disease (PD), with fundamental neuropathological processes of both diseases showing susceptibility of change upon deep sleep modulation. However, promising pharmacological deep sleep enhancement results are hindered by specificity and scalability issues, thus advocating for noninvasive slow-wave activity (SWA) boosting methods to investigate the links between deep sleep and neurodegeneration. Accordingly, we have recently introduced mouse closed-loop auditory stimulation (mCLAS), which is able to successfully boost SWA during deep sleep in neurodegeneration models. Here, we aim at further exploring mCLAS’ acute effect onto disease-specific sleep and wake alterations in AD (Tg2576) and PD (M83) mice. We found that mCLAS adaptively rescues pathological sleep and wake traits depending on the disease-specific impairments observed at baseline in each model. Notably, in AD mice mCLAS significantly increases NREM long/short bout ratio, decreases vigilance state distances by decreasing transition velocities and increases the percentage of cumulative time spent in NREM sleep in the last 3h of the dark period. Contrastingly, in PD mice mCLAS significantly decreases NREM sleep consolidation, by potentiating faster and more frequent transitions between vigilance states, decreases average EMG muscle tone during REM sleep and increases alpha power in WAKE and NREM sleep. Overall, our results indicate that mCLAS selectively prompts an acute alleviation of neurodegeneration-associated sleep and wake phenotypes, by either potentiating sleep consolidation and vigilance state stability in AD or by rescuing bradysomnia and decreasing cortical hyperexcitability in PD. Further experiments assessing the electrophysiological, neuropathological and behavioural long-term effects of mCLAS in neurodegeneration may majorly impact the clinical establishment of sleep-based therapies.</div></div>","PeriodicalId":21874,"journal":{"name":"Sleep medicine","volume":"124 ","pages":"Pages 704-716"},"PeriodicalIF":3.8,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}