Spinal cord最新文献

{"title":"The effect of melatonin administration on motor recovery after spinal cord injury in animal models: a systematic review and meta-analysis","authors":"Ali Khodabakhshi Korelaei, Arash Fallahi, Michael R. Hamblin, Fatemeh Ramezani","doi":"10.1038/s41393-025-01063-3","DOIUrl":"10.1038/s41393-025-01063-3","url":null,"abstract":"Systematic review and meta-analysis. In this study, the effects of the antioxidant melatonin on motor function after spinal cord injury were investigated in preclinical studies. IRAN The search strategy was designed based on keywords related to melatonin and spinal cord injury. The primary screening was based on title and abstract, and the secondary screening was based on the full text of the articles. After extracting data from the articles, statistical analysis was performed using STATA software. Standardized mean differences were used to analyze the results of the included studies. Subgroup analysis and quality control of articles were also performed. Based on the results of 29 separate experiments, melatonin showed a significant strong effect compared to the untreated group. The results showed that IP injection and multiple administrations days had the strong effect in the first three days as well as after 3–4 weeks. But more studies are needed to draw conclusions about its longer term effects. The analysis of MDA, SOD and GSH redox factors showed that the amount of MDA decreased and the amount of GSH increased in the treated animals. Also, the inflammatory factors IL-1Β and TNF-α as well as apoptosis and the rate of neuronal cell death, were reduced in animals that received melatonin, while the number of viable neurons was increased in melatonin treated animals. Melatonin is an antioxidant supplement, which can be considered for clinical trials in human SCI patients. IRAN University of medical sciences","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 3","pages":"135-148"},"PeriodicalIF":2.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469337","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":"Nerve transfers to anterior interosseous nerve for restoration of finger flexion in spinal cord and brachial plexus injury: a systematic Review and individual-patient-data meta-analysis","authors":"Pavlos Texakalidis, Stavros Matsoukas, Nikhil Murthy, Adenike A. Adewuyi, Nader S. Dahdaleh, Colin K. Franz, Kevin Swong","doi":"10.1038/s41393-025-01066-0","DOIUrl":"10.1038/s41393-025-01066-0","url":null,"abstract":"Systematic review and meta-analysis. Cervical spinal cord injury (SCI) and brachial plexus injury (BPI) can result in hand paralysis. Reconstruction of hand motion is associated with improved functionality and quality of life. We synthesized the outcomes of finger and thumb flexion after various nerve transfers to the anterior interosseous nerve (AIN). A systematic literature review and meta-analysis was performed according to the PRISMA guidelines. Successful finger and thumb flexion recovery was defined as Medical research council (MRC) grade ≥3. In total, 23 studies with 99 patients and 120 nerve transfers to the AIN were performed. The mean interval from injury to surgery was 12.8 months and mean follow-up duration was 24 months. Overall, 81/120 (67.5%) and 68/102 (66.7%) hands achieved successful finger and thumb flexion recovery, respectively. Individual-patient-data were available for 94 nerve transfers. Type of injury (SCI vs BPI/peripheral) did not affect finger flexion outcomes (OR 1.92, 95%CI 0.74–5.0, p = 0.17). On multivariate analysis adjusted for mechanism of injury, timing of injury to surgery and duration of follow-up, utilization of the brachioradialis (BR) branch (25%, 1/4, OR 0.01, 95%CI 0.0006–0.44, p = 0.01) and brachialis (BA) branch (59%, 30/51, OR 0.06, 95%CI 0.006–0.68, p = 0.02) as donors, were associated with statistically significant lower odds of successful finger flexion recovery compared to extensor carpi radialis brevis (ECRB) use (95%, 19/20). Similar outcomes were observed with SCI and BPI/peripheral type injuries. ECRB utilization as a donor was superior to BA or BR branch in terms of successful finger flexion recovery.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 3","pages":"127-134"},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441990","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 potential role of RhoA/ROCK-inhibition on locomotor recovery after spinal cord injury: a systematic review of in-vivo studies","authors":"Armin Khavandegar, Negar Sadat Ahmadi, Maryam Alsadat Mousavi, Zahra Ramezani, Elaheh Khodadoust, Mahgol Sadat Hasan Zadeh Tabatabaei, Zahra Hasanpour Segherlou, Arman Zeinaddini-Meymand, Fatemeh Nasehi, Maral Moafi, Kimia RayatSanati, Rasool Masoomi, Sorour Hamidi, Soheila Pourkhodadad, Vafa Rahimi-Movaghar","doi":"10.1038/s41393-025-01064-2","DOIUrl":"10.1038/s41393-025-01064-2","url":null,"abstract":"Systematic Review. To thoroughly assess the existing literature regarding the impact of anti-RhoA/ROCK agents or procedures on functional recovery in animal models of SCI. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences. A comprehensive search was conducted in Ovid MEDLINE, Embase, Scopus, and Web of Science Core Collection utilizing a combination of keywords. All in-vivo animal studies of acute or chronic SCI that evaluated the pharmacological effects of Rho/ROCK inhibitors in English literature were included in this study. Totally, 2320 articles were identified, of which, 60 papers were included for further analysis. A total of 47 (78%) studies were conducted merely on rats, 9 (15%) on mice, 3 (5%) used both, and the remaining used other animals. Y-27632, Fasudil, C3 Transferase and its derivatives (C3-05/PEP-C3/CT04/C3bot154–182/C3bot26mer(156–181)), Ibuprofen, Electroacupuncture (EA), SiRhoA, miR-133b, miR-135-5p, miR-381, miR-30b, Statins, 17β-estradiol, β-elemene, Lentivirus-mediated PGC-1a, Repulsive guidance molecule (RGMa), Local profound hypothermia, Jisuikang (JSK), Hyperbaric oxygen (HBO), Lv-shRhoA (Notch-1 inhibitor), Anti-Ryk antibody, LINGO-antagonist, BA-210, p21Cip1/WAF1, ORL-1 antagonist, Epigallocatechin‐3‐gallate (EGCG), Tamsulosin, AAV.ULK1.DN, and Indomethacin were the 28 reported agents/procedures with anti-RhoA/ROCK effects. The pooled SMD for BBB scores was 0.41 (p = 0.048) in the first week, 0.85 (p < 0.001) in the second week, 1.22 (p = 0.010) in the third week, and 1.53 (p = 0.001) in the fourth week. Of the 28 identified anti-RhoA/ROCK agents, all but two (C3bot and its derivatives and EGCG) demonstrated promising results. The results of the meta-analysis cautiously indicate a significant increase in BBB scores over time after SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 3","pages":"95-126"},"PeriodicalIF":2.1,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433839","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":"Utilization of machine learning algorithm in the prediction of rehospitalization during one-year post traumatic spinal cord injury.","authors":"Salma Aly, Yuying Chen, Abdulaziz Ahmed, Huacong Wen, Tapan Mehta","doi":"10.1038/s41393-024-01055-9","DOIUrl":"https://doi.org/10.1038/s41393-024-01055-9","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>The primary aim was to develop a machine learning (ML) model to predict rehospitalization during the first year of traumatic spinal cord injury (TSCI) and to identify top predictors using data obtained during initial rehabilitation. The secondary aim was to predict prolonged hospital stay among the rehospitalized group.</p><p><strong>Setting: </strong>Eighteen SCI Model Systems centers throughout the United States.</p><p><strong>Methods: </strong>Data were retrieved from the National Spinal Cord Injury Model Systems Database. The participants were divided into 2 groups based on rehospitalization during the first year of injury. Those who experienced rehospitalization during first year were further grouped into prolonged stay (>75th quartile of the total length of stay) or non-prolonged stay. Variables considered in models included socio-demographic factors, clinical characteristics, and comorbidities.</p><p><strong>Results: </strong>The best performing classification models were Random Forest for predicting rehospitalization and Adaptive Boosting for prolonged stay. The most important predictors in both models were the degree of functional independence, American Spinal Injury Association (ASIA) scores, age, days from injury to rehabilitation admission and body mass index. Additionally, for prolonged stays, pressure injury as a reason for rehospitalization was top predictor.</p><p><strong>Conclusion: </strong>Functional Independence Measure (FIM) and ASIA scores emerge as key predictors of both rehospitalizations and prolonged rehospitalizations. These findings may assist clinicians in patient risk assessment. Furthermore, the identification of pressure injury as a primary predictor for prolonged stays signifies a targeted focus on preventive measures for pressure injury-related rehospitalizations, offering a specific strategy to enhance patient care and outcomes.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426345","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":"Exploring the mediating effects of coping strategies on adjustment after sustaining a spinal cord injury.","authors":"Dinalize Purcell, Vegard Strøm, Annelie S Leiulfsrud","doi":"10.1038/s41393-025-01062-4","DOIUrl":"https://doi.org/10.1038/s41393-025-01062-4","url":null,"abstract":"<p><strong>Study design: </strong>Cross-sectional study of adults living with a spinal cord injury (SCI) in Norway.</p><p><strong>Objectives: </strong>Using the Norwegian data from the International Spinal Cord Injury Community Survey (InSCI), we firstly aimed to examine the mediating effect of self-efficacy and active coping strategies on the relationship between functional independence and level of adjustment as proposed by the Spinal Cord Injury Adjustment Model (SCIAM). Secondly, to examine potential gender differences in levels of adjustment after sustaining an SCI. This study used a comprehensive adjustment variable.</p><p><strong>Setting: </strong>SCI population in Norway.</p><p><strong>Methods: </strong>The first objective was tested with a measure of mediation analysis and the second objective with an independent two sample t-test.</p><p><strong>Results: </strong>A total of 610 participants responded to the questionnaire, with a mean age of 57 years, and 68,5% being male. Psychological resources fully mediated the effect of functional independence on adjustment. There was a statistically significant double mediation effect, first through self-efficacy and, then through active coping strategies (β = 0,02; 95% CI 0.01-0.03). The pathway from functional independence through active coping strategies to adjustment showed the strongest mediation proportion of 0.49. The difference in adjustment levels between males and females was 2.90 out of 100 (95% CI: 0.19-5.61).</p><p><strong>Conclusions: </strong>Self-efficacy and active coping strategies were found as mediating factors in the relationship between functional independence and adjustment. These factors are important to consider during SCI rehabilitation. Females had a slightly lower level of adjustment than males.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391927","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":"Retraction Note: Prevalence of prescribed opioid claims among persons with nontraumatic spinal cord dysfunction in Ontario, Canada: a population-based retrospective cohort study","authors":"Qi Guan,&nbsp;Mary-Ellen Hogan,&nbsp;Andrew Calzavara,&nbsp;Daniel McCormack,&nbsp;Aisha K. Lofters,&nbsp;Tejal Patel,&nbsp;Sander L. Hitzig,&nbsp;Tanya Packer,&nbsp;Sara J. T. Guilcher","doi":"10.1038/s41393-025-01061-5","DOIUrl":"10.1038/s41393-025-01061-5","url":null,"abstract":"","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 3","pages":"1-1"},"PeriodicalIF":2.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-025-01061-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient flow problems affecting in-patient spinal cord injury rehabilitation in the Netherlands.","authors":"Linda M M van der Schriek, Marcel W M Post, Catja A Dijkstra, Peter W New, Janneke M Stolwijk-Swüste","doi":"10.1038/s41393-024-01058-6","DOIUrl":"https://doi.org/10.1038/s41393-024-01058-6","url":null,"abstract":"<p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Objectives: </strong>To describe barriers to admission to and discharge from an inpatient rehabilitation unit for patients with newly acquired spinal cord injury or disease (SCI/D) and to identify modifiable factors whereby patient flow can be optimized.</p><p><strong>Setting: </strong>Netherlands.</p><p><strong>Methods: </strong>In-patients with newly acquired SCI/D referred to a rehabilitation centre in the Netherlands between December 2018 and December 2019 were included. Demographic, clinical characteristics and information about waiting days and causes of delay were recorded. Descriptive analysis was used.</p><p><strong>Results: </strong>In total, 105 patients were included; 33 patients (31%) were female, mean age was 59 years, 60% had a non-traumatic SCI/D, 42% of the SCI/D were tetraplegia and 62% were AIS D at referral. No significant differences in demographic or clinical characteristics were found between patients with and without a barrier to admission. Most common admission barriers were bed availability and capacity of nursing and other health staff. The most frequent discharge barriers were delay in care approval, lack of availability of nursing home places and waiting for home modifications.</p><p><strong>Conclusion: </strong>Most frequent admission barriers were availability of beds and staffing capacity; most discharge barriers were problems with home modifications, waiting for care approval or a nursing home place. Recommendations for reducing these barriers are recognizing a potential problem at an early stage, timely communication with patient and/or family about options for discharge, while simultaneously initiating a home modification plan and exploring temporary accommodation options.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042263","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 Sir Ludwig Guttmann lecture 2023: psychosocial factors and adjustment dynamics after spinal cord injury.","authors":"Ashley Craig","doi":"10.1038/s41393-025-01060-6","DOIUrl":"https://doi.org/10.1038/s41393-025-01060-6","url":null,"abstract":"<p><strong>Study design: </strong>Narrative review OBJECTIVES: Sir Ludwig Guttmann realised spinal cord injury (SCI) rehabilitation should incorporate more than a biomedical approach if SCI patients were to adjust to their injury and achieve productive social re-integration. He introduced components into rehabilitation he believed would assist his patients build physical strength as well as psychological resilience that would help them re-engage with their communities. We pay tribute to Sir Ludwig by presenting research that has focussed on psychosocial factors that contribute to adjustment dynamics after SCI.</p><p><strong>Setting: </strong>Not applicable.</p><p><strong>Methods: </strong>Five factors with a psychosocial source will be examined, featured in my research, namely psychological distress, cognitive impairment, pain catastrophizing, sleep disorder and fatigue. A multifactorial model of adjustment will be examined.</p><p><strong>Results: </strong>Evidence shows these factors can be significant barriers to adjustment and reciprocally related to self-efficacy and life decisions. A theoretical rehabilitation framework/model is presented called the SCI Adjustment Model (SCIAM), that explains the process of adjustment dynamics. It describes how multifactorial factors contribute to adjustment in a non-linear process over time.</p><p><strong>Conclusions: </strong>Key clinical messages include: (i) adjustment dynamics will be enhanced if viewed through the lens of a multifactorial model that clarifies how multiple psychosocial factors can combine and act as barriers or facilitators to adjustment; (ii) judiciously using this information, assess and then strategize to reduce the influence of barriers or strengthen facilitators during SCI rehabilitation and beyond, and (iii) integrate psychosocial guidelines and a person-centred approach into SCI rehabilitation to achieve treatment goals.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011940","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":"Evaluation of a new model of care for bladder management in a statewide spinal cord service.","authors":"Belinda J Gabbe, Stacey Rj Haughton, Andrew Nunn, Marnie Graco, Chris Michael, Sandra Reeder, Rebekah McGaw, David J Berlowitz","doi":"10.1038/s41393-024-01059-5","DOIUrl":"https://doi.org/10.1038/s41393-024-01059-5","url":null,"abstract":"<p><strong>Study design: </strong>Registry-based cohort study.</p><p><strong>Objectives: </strong>To evaluate the impact of the introduction of a new bladder management model of care at the Victorian Spinal Cord Service (VSCS) on the incidence of subsequent emergency department presentations and readmissions to hospital for urinary tract infection (UTI) in the first 2 years after injury.</p><p><strong>Setting: </strong>VSCS, Austin Health, Melbourne, Australia.</p><p><strong>Methods: </strong>A new model of care that prioritized intermittent self-catheterization was implemented at the VSCS on 1 August 2017. Data from the Victorian State Trauma Registry and Austin Health medical record were used to compare the rate of readmissions, emergency department (ED) presentations and hospitalisations for UTI in the first two years post-injury before and after practice was changed.</p><p><strong>Results: </strong>A total of 333 cases were included; 149 cases pre-model of care change and 184 cases after. 143 males and 41 females with a mean (SD) age of 48.9 (19.7) were admitted to the VSCS following the change in model of care. The rate of any subsequent hospitalisation for UTI (ED presentation or admission) was lower following the introduction of the new bladder management model of care (Incidence rate ratio 0.30, 95% CI 0.12-0.73).</p><p><strong>Conclusions: </strong>Our data demonstrates the real-world impact of a change in bladder management after new SCI. These data strengthen the consensus recommendation in current practice guidelines.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011938","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":"Diagnostic evaluation and management of recurrent urinary tract infections in the spinal cord injury population – a retrospective evaluation at a tertiary care center","authors":"Christopher S. Elliott,&nbsp;Hien-Khanh Huynh,&nbsp;Kazuko Shem","doi":"10.1038/s41393-024-01037-x","DOIUrl":"10.1038/s41393-024-01037-x","url":null,"abstract":"Retrospective review. While most individuals with spinal cord injury (SCI) are expected to have 1-2 urinary tract infections (UTIs) per year, there is a subset with higher incidence. We evaluate our practice to characterize common causes of recurrent UTIs, hypothesizing that more frequent infections typically have addressable risk factors. Tertiary urology clinic, San Jose, CA. We reviewed patients with SCI referred to a tertiary urology clinic for evaluation and management of “recurrent UTIs” during the years 2015–2020. Following workup, the suspected cause of recurrent UTIs and number of post-specialty evaluation UTIs (patient reported) were noted. Forty persons with SCI with a mean of 4.8 UTI treatments in the prior year comprised our cohort with most performing CIC (80%). After workup, 37/40 (92.5%) had a likely cause for their reported recurrent UTIs. In 16/40 (40%), careful questioning determined that the patient was not having UTIs based on guideline definitions. In those with confirmed recurrent UTIs, a bladder diary (62.5%) or urodynamic study (64%) was more likely to identify a cause compared to imaging (2.6%) or cystoscopy (8%). With a minimum 1-year follow-up, 90% of our population had a 50% or more reduction in UTI incidence, mostly using non-antibiotic strategies. In a referral SCI population with a chief complaint of “recurrent UTIs”, over a third were not having UTIs. In addition to detailed history, a bladder diary +/− urodynamics are most useful in finding the cause and improving UTI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 3","pages":"1-6"},"PeriodicalIF":2.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967027","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}