Spinal cord最新文献

{"title":"Providing a QuickStart for people with newly acquired spinal cord injury: a new model of care offering in-reach advice and support","authors":"Susan M. Stoikov, Chau T. D. Do, Kiley J. Pershouse, Claire E. Panagoda, Donna G. Harre, Delena I. Amsters","doi":"10.1038/s41393-025-01086-w","DOIUrl":"10.1038/s41393-025-01086-w","url":null,"abstract":"Descriptive study of a pilot model of care named QuickStart. To describe the eligibility, rehabilitation pathways, team composition, and service delivery of a novel model of care for people with newly acquired spinal cord injuries (SCI). Queensland Spinal Cord Injuries Service, Metro South Health, Queensland, Australia. In April 2022, QuickStart was established with a multidisciplinary team of health professionals to provide early in-reach specialist SCI expertise to individuals with newly acquired spinal cord injury and their treating clinicians. Between July 2022 and June 2024, QuickStart accepted 508 patients who were admitted to a Queensland or northern New South Wales hospital. Patients who received QuickStart support followed one of two pathways: they completed their primary rehabilitation in the Spinal Injuries Unit (SIU) at Princess Alexandra Hospital or at another facility. QuickStart provides specialised SCI support to patients and their treating team via a range of modalities including face-to-face review, telephone and videoconference. Referral numbers increased by 22% from the first year of operation, along with a 38% increase in the average QuickStart caseload. Patients received, on average, 12 occasions of service and a total service provision time of 452 min. All QuickStart patients received referrals to other specialised SCI community services within the Queensland Spinal Cord Injuries Service. QuickStart is a promising model of care that has improved access to specialised SCI expertise for individuals with newly acquired SCI, particularly those who may not have immediate access to specialised rehabilitation services.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 6","pages":"285-291"},"PeriodicalIF":2.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982727","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":"Management of pressure injuries with associated osteomyelitis in people with spinal cord injury: a national survey of referral centers in France","authors":"Hélène Le Liepvre, Emma D’Anglejan, Haude Chaussard, Damien Marmouset, Killian Allepot, Frédérique Bouchand, Latifa Noussair, François Genêt, Vincent T. Carpentier, Aurélien Dinh","doi":"10.1038/s41393-025-01084-y","DOIUrl":"10.1038/s41393-025-01084-y","url":null,"abstract":"Pressure injuries are common among individuals with spinal cord injury and often complicated by superinfection, leading to sepsis, hospitalizations, and significant healthcare costs. Osteomyelitis associated with pressure injuries poses diagnostic challenges and requires effective medical and surgical management. To investigate current practices, a national survey of French centers managing over 20 cases annually was conducted. Results revealed significant variability in surgical techniques, antibiotic protocols, and people care pathways. Musculocutaneous and perforator flaps were commonly used, but their application differed among centers. No flaps were performed during acute infections due to failure risks. Bedridden periods and hip flexion protocols varied, with prolonged immobility linked to complications such as thromboembolism and malnutrition. Antibiotic durations ranged from 5–180 days, reflecting differing approaches to infection management. Cure rates within one year ranged from 70–90%. These findings underscore the need for standardized, evidence-based protocols to optimize care for this vulnerable population.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 6","pages":"319-322"},"PeriodicalIF":2.2,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027186","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":"Identification of disulfidptosis-related genes and subgroups in spinal cord injury","authors":"Ye Tao, Shanhe Wang, Xiongfei Li, Letian Jin, Chen Liu, Kun Jiao, Xiaoyu Li, Yajun Cheng, Kehan Xu, Xiaoyi Zhou, Xianzhao Wei","doi":"10.1038/s41393-025-01081-1","DOIUrl":"10.1038/s41393-025-01081-1","url":null,"abstract":"Bioinformatics analysis and experimental validation study. To investigate the role and expression patterns of disulfidptosis-related genes in spinal cord injury (SCI), identify potential pivotal genes, and explore possible therapeutic targets. Shanghai, China. Data acquisition and pre-processing: Screened 27 disulfidptosis-related genes based on literature and downloaded RNA-sequencing data of ASCI patients from GEO database (GSE151371); Identification of differentially expressed genes (DEGs): Used R package “limma” for differential gene expression analysis between ASCI samples and normal controls; Evaluating immune cell infiltration: Employed ssGSEA algorithm and CIBERSORT to determine immune cell abundance; Identification and functional verification of key genes: Intersected disulfidptosis-related genes with DEGs, and used machine learning techniques (Random Forest, Lasso, Support Vector Machine) to identify hub genes. Validated hub genes expression by real-time PCR; Construction of a diagnostic model: Developed a backpropagation neural network clinical prediction model based on hub genes and clinical features, and evaluated its performance using ROC curve. 6. Subcluster analysis: Performed consensus cluster analysis of ASCI samples and hub genes, and used GSVA to elucidate functional differences between subgroups. Identified 7764 DEGs in ASCI, with GO and KEGG enrichment in inflammation and autophagy-related pathways; Found differences in immune cell infiltration between ASCI and control groups, and correlation between immune cells and DRGs; Determined seven hub genes (MYL6, NUBPL, CYFIP1, IQGAP1, FLNB, SLC7A11, CD2AP) through machine learning; Validated the expression of hub genes by qRT-PCR; Constructed a clinical diagnostic model with good predictive accuracy (overall dataset accuracy of 83.3%); Identified two subtypes of ASCI based on hub genes, with different immune infiltration and pathway activity. Disulfidptosis is closely related to spinal cord injury. The identified hub genes and subtypes provide new insights for biomarker and therapeutic target research. The diagnostic model has potential for clinical application, but further studies are needed due to limitations such as small sample size. This study was supported in part by the project of Youth Scientific and Technological Talents of PLA (2020QN06125), Changhong Talent Project in First affiliated hospital of Navy Medical University (Wei Xianzhao) and Basic Medical Research Project in First affiliated hospital of Navy Medical University (2023PY17). I want to reiterate that there is no prior publication of figures or tables and no conflict of interest in the submission of this manuscript.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 6","pages":"306-318"},"PeriodicalIF":2.2,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017862","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":"Factors affecting return to work after spinal cord injury in Japan: a cross-sectional study","authors":"Tetsuo Hayashi, Hiromitsu Kobayashi, Momo Irie, Hiroaki Sakai, Mayumi Takegawa, Ryota Takanami, Muneaki Masuda, Kensuke Kubota, Mari Sato, Osamu Kawano, Takeshi Maeda","doi":"10.1038/s41393-025-01083-z","DOIUrl":"10.1038/s41393-025-01083-z","url":null,"abstract":"Survey. This study aimed to investigate the rate of return to work among individuals with spinal cord injuries in Japan and identify factors associated with their return. Returning to work is difficult for people with spinal cord injuries, although it contributes to their personal quality of life and society. Previous studies have examined various factors inhibiting return to work, but none have examined social participation. Questionnaires were sent to individuals of working age with spinal cord injuries. Their employment status, marital status, neurological status, activities of daily living, enjoyment of sports and/or hobbies post-injury, and whether they lived with family were examined using the visual analog scale for pain. Among the 134 respondents, 61 (46%) were employed at the time of the survey. Multivariate logistic regression analysis revealed that mild paralysis and enjoyment of sports and/or hobbies were significant factors associated with return to work. Among those employed, 27% secured jobs through private job introductions, highlighting the role of social connections in facilitating employment. Besides mild paralysis, social participation in sports and/or hobbies was significantly associated with a return to work. As social connections can provide opportunities to obtain jobs, providing spaces for interaction through sports and hobbies, can create a conducive environment for returning to work.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 6","pages":"279-284"},"PeriodicalIF":2.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035527","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":"Priorities for support service needs among individuals with spinal cord injury","authors":"Hye Jin Nam, Haesun Lee, Ju Young Yoon","doi":"10.1038/s41393-025-01079-9","DOIUrl":"10.1038/s41393-025-01079-9","url":null,"abstract":"Cross-sectional survey. This study aims to identify and prioritize the gaps between the required and current levels of support services for individuals with SCI in South Korea. Community. The cross-sectional analysis involved 532 participants who are members of the Korea Spinal Cord Injury Association. These participants were recruited through the 2021 Survey on Needs of People with SCI, conducted via face-to-face interviews by trained investigators. The survey assesses the demand and current levels of 11 key support services. The Borich needs assessment and the locus for focus model were employed to identify the priorities of these services. Results indicated significant disparities between the required and current levels across all services. Among the 532 participants, 70.1% were male and the average age was 49.6 years. The highest priority services were identified as “support for caregiver costs,” “livelihood security,” “health management,” and “home modification”. Secondary priorities included “training for daily living activities” and “vocational rehabilitation.” The study emphasizes the importance of aligning service provision with the specific needs of the SCI population to enhance their quality of life and promote successful reintegration into the community. The findings underscore the urgent need for comprehensive support systems to address the economic and functional challenges of individuals with SCI. Policymakers and service providers are encouraged to focus on these identified priorities to better meet the needs of individuals with SCI, to ensure their sustained independence and improved well-being.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 6","pages":"298-305"},"PeriodicalIF":2.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987660","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":"Quantifying guideline-discordant intermittent catheterization in adults hospitalized with spinal cord injury: a retrospective cohort study","authors":"Mengdong He, Emily Hon, Lin Xu, Stephen Hampton, Kimberly Waddell","doi":"10.1038/s41393-025-01078-w","DOIUrl":"10.1038/s41393-025-01078-w","url":null,"abstract":"Retrospective cohort study. To characterize guideline-discordant clean intermittent catheterization (CIC) during hospitalizations of patients with spinal cord injury (SCI), explore predictors of guideline-discordant CIC, and examine its association with urinary tract infection (UTI). Acute care hospitals within a large academic health system. Using electronic health records (9/1/2021-9/30/2023), we identified adults hospitalized with a discharge diagnosis of SCI and ≥1 documented CIC bladder output. The primary outcome was guideline-discordant CIC (bladder output volume >500 mL and/or time between CIC > 6 h). Generalized linear model and Chi-square test were used to evaluate patient factors and UTI risk associated with guideline-discordant CIC. The study included 413 patients with SCI covering 8,016 CIC measurements during 519 hospitalizations. Their mean (SD) age was 55.2 (20.6) years, with 34.7% female and 46.8% Black. 52.8% were covered by Medicare. 79.4% had a thoracolumbar-level SCI. 50.2% of CICs were guideline-discordant. Males and those with managed care insurance had significantly higher odds of guideline-discordant CIC (OR = 1.34, 95% CI, 1.03 to 1.73 and OR = 2.05, 95% CI, 1.18 to 3.54, respectively). Patients with an indwelling catheter for ≥12 days before initiating CIC had significantly lower odds of guideline-discordant CIC (OR = 0.65, 95% CI, 0.49 to 0.84). The UTI incidence was 12.5% in hospitalizations with guideline-discordant CIC compared to 10.4% with guideline-concordant CIC (P = 0.49). Half of CICs did not adhere to guidelines, highlighting the need for quality improvement initiatives. Further research examining the association between UTI and CIC care patterns is warranted.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 5","pages":"270-276"},"PeriodicalIF":2.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12074987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044613","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":"Flap reconstruction of pressure ulcers in patients with spinal cord injury: a retrospective cohort study","authors":"Ankit Mishra, Mohammed Eldolify, Rebecca Shirley, James K-K Chan","doi":"10.1038/s41393-025-01080-2","DOIUrl":"10.1038/s41393-025-01080-2","url":null,"abstract":"Retrospective case series. To describe our five-year experience of surgical excision and flap reconstruction of pressure ulcers in individuals with spinal cord injury (SCI). Tertiary spinal centre in Stoke Mandeville, United Kingdom. All spinal injury patients that underwent surgical reconstruction of pressure ulcers at the Stoke Mandeville Hospital National Spinal Injury Centre between 2018 and 2022 inclusive were included. Ulcers underwent ‘pseudotumour’ excision followed by either immediate or staged flap reconstruction. The primary outcome was complete healing at one year. Secondary outcomes included flap loss, complications, and return to theatre. 52 cases were included across 44 patients. 43 cases (82.7%) underwent immediate debridement and reconstruction. The mean number of procedures was 1.9 (range 1–6). Local flaps were used in 22 (41.5%) cases. There was one (1.9%) free flap (anterolateral thigh), eight (15.4%) pedicled flaps, and 21 (39.6%) flaps based on single perforators. 49 cases completed follow-up; 41 (83.7%) were healed at one year after their initial surgery. Immediate reconstructions were 36.7% more likely to achieve healing at this time point than staged cases (P = .028, Fisher’s exact). There was partial or total flap loss in 15 (28.8%) cases. Thirty-nine complications were seen in 24 (46.2%) cases. Twenty-three cases (44.2%) required returns to theatre. Surgical debridement with flap reconstruction is a safe and reliable treatment approach for pressure ulcers in those with SCI, with a complication rate comparable to existing literature. Immediate flap reconstruction and local flap designs may be associated with a lower risk of complications and higher healing rates.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 6","pages":"292-297"},"PeriodicalIF":2.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039546","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":"BDNF-GABA signaling in astrocytes: enhancing neural repair after SCI through MSC therapies","authors":"Qingsheng Zhou, Qiongxuan Fang, Chunming Zhang, Wei Liu, Yifeng Sun","doi":"10.1038/s41393-025-01077-x","DOIUrl":"10.1038/s41393-025-01077-x","url":null,"abstract":"An integrated bioinformatics data study. This study, through bioinformatics analysis, aims to map the landscape of astrocytes, explore key signaling pathways, and uncover molecular mechanisms that support SCI recovery facilitated by MSCs and iPSCs. Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University. We performed a bioinformatics analysis of single-cell transcriptomes (scRNA-seq), spatial transcriptomics, and bulk RNA-seq data sourced from Gene Expression Omnibus (GEO) datasets. The data processing involved R packages like “Seurat,” “DESeq2,” and “WGCNA.” For pathway enrichment, we used Gene Set Enrichment Analysis (GSEA) and the Enrichr web server. Single-cell and spatial transcriptomic analysis revealed notable changes in the astrocyte landscape after SCI, highlighting a significant disruption in astrocyte populations within the injured region. Findings suggest that BDNF regulation of GABA neurotransmission and GABA receptor signaling in astrocytes plays a key role in promoting neuronal regeneration. Additionally, hUC-MSCs were found to enhance neural repair by activating BDNF-regulated GABA signaling of astrocytes. A promising alternative involves iPS-derived MSCs, which have shown potential to boost neural regeneration through BDNF, GABA, and GABA receptor signaling pathways of astrocytes. In summary, SCI disrupts astrocyte populations, impacting their ability to support neural repair. BDNF-regulated GABA signaling in astrocytes is essential for neuron regeneration. Both hUC-MSCs and iPS-derived MSCs show promise in enhancing neural recovery by activating these pathways, offering potential new therapeutic options for SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 5","pages":"263-269"},"PeriodicalIF":2.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062225","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":"Factors impacting employment outcomes for persons with spinal cord injury in South Korea","authors":"Kwang-Jin Jung, Yong-Tak Kim, Mi-Ri Jeon, Chan-Woo Lee, Keum-Jin Lee","doi":"10.1038/s41393-025-01076-y","DOIUrl":"10.1038/s41393-025-01076-y","url":null,"abstract":"Cross-sectional survey. To identify the factors determining the employment of individuals with spinal cord injury (SCI) living in South Korea, which shows a lower-than-average employment rate in international comparative studies, and to examine the potential importance for policy. Community of patients with SCI who are members of the Korea Spinal Cord Injury Association (KSCIA). A survey involving 200 members of the KSCIA was conducted. In the analysis, we included 177 individuals aged 15–64 years and were at least 2 years post-injury at the time of the survey. Descriptive statistics were calculated and logistic regression was applied to examine the association between 11 variables and employment outcomes. A higher “education level” and participation in “vocational rehabilitation services” were positively associated with employment for individuals with SCI. By contrast, “receiving welfare benefits” was negatively associated with employment probability. The analysis, which categorized employment predictors into human capital, injury, and environmental models, showed no associations for factors in the Injury Model but indicated positive associations for education in the Human Capital Model and for receiving compensation in the form of welfare benefits and participation in vocational rehabilitation services in the Environment Model. Among the three models, the Environment Model had the greatest explanatory power. This suggests that in Korea, policy interventions targeting modifiable environmental factors hold significant potential to improve employment outcomes for individuals with SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 5","pages":"257-262"},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721545","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 feasibility and utility of intraoperative ultrasound in spinal cord injury patients: an international survey of AO spine members","authors":"Chris J. Neal, Olesja Hazenbiller, Christoph P. Hofstetter, Bizhan Aarabi, James S. Harrop, Michael G. Fehlings, Shekar Kurpad, Vafa Rahimi-Movaghar, Brian K. Kwon, James D. Guest","doi":"10.1038/s41393-025-01072-2","DOIUrl":"10.1038/s41393-025-01072-2","url":null,"abstract":"Survey. Intraoperative ultrasound (IOUS) is an emerging tool for assessing the injured spinal cord during surgical intervention and particularly after traumatic spinal cord injury (SCI). The extent of utilization of this technique is unknown. To assess whether a knowledge gap exists regarding IOUS in managing SCI patients, an international survey of spine surgeons was performed. International Survey. Members of the AO Spine international community were surveyed using a web-based questionnaire developed by an SCI expert commission. The categorical data were analyzed descriptively. Of the 276 completed surveys, 22% (n = 61/276) indicated IOUS was utilized during spine surgery, with most responses coming from Europe (38% n = 24/61) and North America (30% n = 18/61). Only 41% (n = 25/61) had received formal IOUS training. There were 59% (n = 36/61) of respondents who indicated they use IOUS on patients with acute SCI, mainly to assess adequate decompression. Of those not using IOUS, 50% (n = 107/215) did not have access to an ultrasound machine available. Overall, 92% (n = 254/276) indicated that an IOUS training course would be beneficial to improve understanding and patient care. This international survey of spine surgeons demonstrated that currently, there is limited use of IOUS in the surgical management of acute SCI. Understanding the needs of spine surgeons and tailoring educational opportunities may increase the role of IOUS. Given the importance of surgical decompression in enhancing outcomes after acute SCI coupled with the ability of IOUS to assess decompression, greater adoption of IOUS could further enhance the efficacy of decompressive surgery.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 5","pages":"252-256"},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711364","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}