Stroke and Vascular Neurology最新文献

{"title":"Tranexamic acid for intracerebral haemorrhage within 2 hours of onset: protocol of a phase II randomised placebo-controlled double-blind multicentre trial.","authors":"Nawaf Yassi,&nbsp;Henry Zhao,&nbsp;Leonid Churilov,&nbsp;Bruce C V Campbell,&nbsp;Teddy Wu,&nbsp;Henry Ma,&nbsp;Andrew Cheung,&nbsp;Timothy Kleinig,&nbsp;Helen Brown,&nbsp;Philip Choi,&nbsp;Jiann-Shing Jeng,&nbsp;Annemarei Ranta,&nbsp;Hao-Kuang Wang,&nbsp;Geoffrey C Cloud,&nbsp;Rohan Grimley,&nbsp;Darshan Shah,&nbsp;Neil Spratt,&nbsp;Der-Yang Cho,&nbsp;Karim Mahawish,&nbsp;Lauren Sanders,&nbsp;John Worthington,&nbsp;Ben Clissold,&nbsp;Atte Meretoja,&nbsp;Vignan Yogendrakumar,&nbsp;Mai Duy Ton,&nbsp;Duc Phuc Dang,&nbsp;Nguyen Thai My Phuong,&nbsp;Huy-Thang Nguyen,&nbsp;Chung Y Hsu,&nbsp;Gagan Sharma,&nbsp;Peter J Mitchell,&nbsp;Bernard Yan,&nbsp;Mark W Parsons,&nbsp;Christopher Levi,&nbsp;Geoffrey A Donnan,&nbsp;Stephen M Davis","doi":"10.1136/svn-2021-001070","DOIUrl":"https://doi.org/10.1136/svn-2021-001070","url":null,"abstract":"<p><strong>Rationale: </strong>Haematoma growth is common early after intracerebral haemorrhage (ICH), and is a key determinant of outcome. Tranexamic acid, a widely available antifibrinolytic agent with an excellent safety profile, may reduce haematoma growth.</p><p><strong>Methods and design: </strong>Stopping intracerebral haemorrhage with tranexamic acid for hyperacute onset presentation including mobile stroke units (STOP-MSU) is a phase II double-blind, randomised, placebo-controlled, multicentre, international investigator-led clinical trial, conducted within the estimand statistical framework.</p><p><strong>Hypothesis: </strong>In patients with spontaneous ICH, treatment with tranexamic acid within 2 hours of onset will reduce haematoma expansion compared with placebo.</p><p><strong>Sample size estimates: </strong>A sample size of 180 patients (90 in each arm) would be required to detect an absolute difference in the primary outcome of 20% (placebo 39% vs treatment 19%) under a two-tailed significance level of 0.05. An adaptive sample size re-estimation based on the outcomes of 144 patients will allow a possible increase to a prespecified maximum of 326 patients.</p><p><strong>Intervention: </strong>Participants will receive 1 g intravenous tranexamic acid over 10 min, followed by 1 g intravenous tranexamic acid over 8 hours; or matching placebo.</p><p><strong>Primary efficacy measure: </strong>The primary efficacy measure is the proportion of patients with haematoma growth by 24±6 hours, defined as either ≥33% relative increase or ≥6 mL absolute increase in haematoma volume between baseline and follow-up CT scan.</p><p><strong>Discussion: </strong>We describe the rationale and protocol of STOP-MSU, a phase II trial of tranexamic acid in patients with ICH within 2 hours from onset, based in participating mobile stroke units and emergency departments.</p>","PeriodicalId":22021,"journal":{"name":"Stroke and Vascular Neurology","volume":" ","pages":"158-165"},"PeriodicalIF":5.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/85/svn-2021-001070.PMC9067256.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39680007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early cisternal fibrinolysis is more effective than rescue spasmolysis for the prevention of delayed infarction after subarachnoid haemorrhage.","authors":"Roland Roelz,&nbsp;Christian Scheiwe,&nbsp;Jürgen Grauvogel,&nbsp;Istvan Csok,&nbsp;Volker Arnd Coenen,&nbsp;Jürgen Beck,&nbsp;Peter C Reinacher","doi":"10.1136/svn-2021-001146","DOIUrl":"https://doi.org/10.1136/svn-2021-001146","url":null,"abstract":"<p><strong>Background: </strong>To compare the efficacy of two different concepts of cisternal therapy-PREVENTIVE fibrinolysis plus on-demand spasmolysis versus RESCUE spasmolysis-for the prevention of cerebral vasospasm (CVS) and delayed cerebral infarction (DCI) in patients with aneurysmal subarachnoid haemorrhage (aSAH).</p><p><strong>Methods: </strong>Retrospective analysis of 84 aSAH patients selected for cisternal therapy for DCI prevention. 66 high-risk patients received PREVENTIVE cisternal therapy to enhance blood clearance. Either stereotactic catheter ventriculocisternostomy (STX-VCS) or intraoperative placement of a cisterno-ventriculostomy catheter (CVC), followed by fibrinolytic cisternal lavage using urokinase was performed. In case of vasospasm, nimodipine was applied intrathecally. 22 low-risk patients who developed CVS against expectations were selected for STX-VCS as RESCUE intervention for cisternal spasmolysis with nimodipine. Rates of DCI and mean flow velocities of daily transcranial Doppler (TCD) ultrasonographies were evaluated.</p><p><strong>Results: </strong>Despite a higher prespecified DCI risk, patients selected for PREVENTIVE intervention primarily aiming at blood clearance had a lower DCI rate compared with patients selected for intrathecal spasmolysis as a RESCUE therapy (11.3% vs 18.2%). After intrathecal treatment onset, CVS (TCD>160 cm/s) occurred in 45% of patients with PREVENTIVE and 77% of patients with RESCUE therapy (p=0.013). A stronger response of CVS to intrathecal nimodipine was observed in patients with PREVENTIVE intervention as the mean CVS duration after start of intrathecal nimodipine was 3.2 days compared with 5.8 days in patients with RESCUE therapy (p=0.026).</p><p><strong>Conclusions: </strong>PREVENTIVE cisternal therapy directed at blood clearance is more effective for the prevention of CVS and delayed infarction compared with cisternal RESCUE spasmolysis.</p><p><strong>Trial registration number: </strong>DRKS00016532.</p>","PeriodicalId":22021,"journal":{"name":"Stroke and Vascular Neurology","volume":"7 2","pages":"108-113"},"PeriodicalIF":5.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/e5/svn-2021-001146.PMC9067274.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10238081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision antiplatelet therapy for the prevention of ischaemic stroke.","authors":"David Wang","doi":"10.1136/svn-2021-001383","DOIUrl":"https://doi.org/10.1136/svn-2021-001383","url":null,"abstract":"Antiplatelet ST- Segment Myocardial Infarction Patient Outcome PCI: Tailored Antiplatelet Therapy PCI","PeriodicalId":22021,"journal":{"name":"Stroke and Vascular Neurology","volume":" ","pages":"89-91"},"PeriodicalIF":5.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4e/89/svn-2021-001383.PMC9067268.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39663529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician's perspectives in using head impulse-nystagmus-test of skew (HINTS) for acute vestibular syndrome: UK experience.","authors":"Charlotte L Warner,&nbsp;Lisa Bunn,&nbsp;Nehzat Koohi,&nbsp;Gunnar Schmidtmann,&nbsp;Jennifer Freeman,&nbsp;Diego Kaski","doi":"10.1136/svn-2021-001229","DOIUrl":"https://doi.org/10.1136/svn-2021-001229","url":null,"abstract":"<p><strong>Background: </strong>Acute vestibular syndrome (AVS) features continuous dizziness and may result from a benign inner ear disorder or stroke. The head impulse-nystagmus-test of skew (HINTS) bedside assessment is more sensitive than brain MRI in identifying stroke as the cause of AVS within the first 24 hours. Clinicians' perspectives of the test in UK secondary care remains unknown. Here, we explore front-line clinicians' perspectives of use of the HINTS for the diagnosis of AVS.</p><p><strong>Methods: </strong>Clinicians from two large UK hospitals who assess AVS patients completed a short online survey, newly designed with closed and open questions.</p><p><strong>Results: </strong>Almost half of 73 total responders reported limited (n=33), or no experience (n=19), reflected in low rates of use of HINTS (n=31). While recognising the potential utility of HINTS, many reported concerns about subjectivity, need for specialist skills and poor patient compliance. No clinicians reported high levels of confidence in performing HINTS, with 98% identifying training needs. A lack of formalised training was associated with onward specialist referrals and neuroimaging (p=0.044).</p><p><strong>Conclusions: </strong>Although the low sample size in this study limits the generalisability of findings to wider sites, our preliminary data identified barriers to the application of the HINTS in AVS patients and training needs to improve rapid, cost-effective and accurate clinical diagnosis of stroke presenting with vertigo.</p>","PeriodicalId":22021,"journal":{"name":"Stroke and Vascular Neurology","volume":"7 2","pages":"172-175"},"PeriodicalIF":5.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/bf/svn-2021-001229.PMC9067262.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10612499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transient global amnesia and stroke: not that benign?","authors":"Michele Romoli,&nbsp;Lorenzo Muccioli","doi":"10.1136/svn-2021-001384","DOIUrl":"https://doi.org/10.1136/svn-2021-001384","url":null,"abstract":"","PeriodicalId":22021,"journal":{"name":"Stroke and Vascular Neurology","volume":"7 2","pages":"92-93"},"PeriodicalIF":5.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1e/5c/svn-2021-001384.PMC9067263.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10238083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AHORA: a Spanish language tool to identify acute stroke symptoms.","authors":"Paul Banerjee,&nbsp;Helene Koumans,&nbsp;Madison Danielle Weech,&nbsp;Maricela Wilson,&nbsp;Mark Rivera-Morales,&nbsp;Latha Ganti","doi":"10.1136/svn-2021-001280","DOIUrl":"https://doi.org/10.1136/svn-2021-001280","url":null,"abstract":"<p><strong>Objective: </strong>To develop a Spanish language tool for acute stroke identification.</p><p><strong>Methods: </strong>A Spanish language translation of the Balance-Eyes-Face-Arm-Speech-Time tool was developed within our emergency medical services agency.</p><p><strong>Results: </strong>The authors present a new prehospital stroke tool, Andar, Hablar, Ojos, Rostro and Ambos Brazos o Piernas (AHORA) (which means now in Spanish) to help combat the language barrier and reinforce the necessity to call 9-1-1 as soon as any stroke symptoms are noted.</p><p><strong>Conclusion: </strong>AHORA is a Spanish language tool that aims to help Spanish-speaking individuals to identify an acute stroke and obtain prompt help.</p>","PeriodicalId":22021,"journal":{"name":"Stroke and Vascular Neurology","volume":"7 2","pages":"176-178"},"PeriodicalIF":5.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/1b/svn-2021-001280.PMC9067269.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9794286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lesion-symptom mapping with NIHSS sub-scores in ischemic stroke patients.","authors":"Deepthi Rajashekar,&nbsp;Matthias Wilms,&nbsp;M Ethan MacDonald,&nbsp;Serena Schimert,&nbsp;Michael D Hill,&nbsp;Andrew Demchuk,&nbsp;Mayank Goyal,&nbsp;Sean P Dukelow,&nbsp;Nils Daniel Forkert","doi":"10.1136/svn-2021-001091","DOIUrl":"https://doi.org/10.1136/svn-2021-001091","url":null,"abstract":"<p><strong>Background: </strong>Lesion-symptom mapping (LSM) is a statistical technique to investigate the population-specific relationship between structural integrity and post-stroke clinical outcome. In clinical practice, patients are commonly evaluated using the National Institutes of Health Stroke Scale (NIHSS), an 11-domain clinical score to quantitate neurological deficits due to stroke. So far, LSM studies have mostly used the total NIHSS score for analysis, which might not uncover subtle structure-function relationships associated with the specific sub-domains of the NIHSS evaluation. Thus, the aim of this work was to investigate the feasibility to perform LSM analyses with sub-score information to reveal category-specific structure-function relationships that a total score may not reveal.</p><p><strong>Methods: </strong>Employing a multivariate technique, LSM analyses were conducted using a sample of 180 patients with NIHSS assessment at 48-hour post-stroke from the ESCAPE trial. The NIHSS domains were grouped into six categories using two schemes. LSM was conducted for each category of the two groupings and the total NIHSS score.</p><p><strong>Results: </strong>Sub-score LSMs not only identify most of the brain regions that are identified as critical by the total NIHSS score but also reveal additional brain regions critical to each function category of the NIHSS assessment without requiring extensive, specialised assessments.</p><p><strong>Conclusion: </strong>These findings show that widely available sub-scores of clinical outcome assessments can be used to investigate more specific structure-function relationships, which may improve predictive modelling of stroke outcomes in the context of modern clinical stroke assessments and neuroimaging.</p><p><strong>Trial registration number: </strong>NCT01778335.</p>","PeriodicalId":22021,"journal":{"name":"Stroke and Vascular Neurology","volume":" ","pages":"124-131"},"PeriodicalIF":5.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/21/svn-2021-001091.PMC9067270.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39659980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, prevalence and risk of stroke in patients with Takayasu arteritis: a nationwide population-based study in South Korea.","authors":"Sung Soo Ahn,&nbsp;Minkyung Han,&nbsp;Yong-Beom Park,&nbsp;Inkyung Jung,&nbsp;Sang-Won Lee","doi":"10.1136/svn-2020-000809","DOIUrl":"https://doi.org/10.1136/svn-2020-000809","url":null,"abstract":"<p><strong>Background: </strong>Takayasu arteritis (TAK) is a disease associated with increased risk of cardiovascular complications. We aimed to evaluate the incidence, prevalence and risk of stroke in patients with TAK.</p><p><strong>Methods: </strong>Data from 1065 patients were obtained from a national database (2010-2018). The annual incidence and prevalence per 100 000 persons were estimated using the registration population in the midst of every year, and the standardised incidence ratio (SIR) of stroke was compared with the general population based on the data from the 2006 national report for cardiovascular and cerebrovascular diseases. Age-adjusted incidence rate ratio (IRR) of stroke based on the time interval after diagnosis was also calculated. A time-dependent Cox regression was conducted to investigate predictive factors of stroke.</p><p><strong>Results: </strong>The overall incidence rate of TAK ranged between 0.2 and 0.3/100 000 person-years annually; the prevalence of TAK gradually increased, reaching 3.25/100 000 person-years in 2018. Seventy-three (6.9%) patients experienced stroke during follow-up, and the risk of developing stroke was higher than the general population (overall SIR 7.39, 95% CI 5.79 to 9.29; men: SIR 5.70, 95% CI 2.84 to 10.20; women: SIR 7.06, 95% CI 5.41 to 9.05). Most stroke events (90.9%) were cerebral infarction for men, whereas the proportion of cerebral infarction was lower (62.9%) in women. Over half of stroke events occurred within 6 months after diagnosis, and stroke was more common within 6 months of diagnosis compared with after 3 years in women (IRR 13.46, 95% CI 6.86 to 26.40). In Cox regression analysis, age was the sole predictor of stroke (adjusted HR 1.02, 95% CI 1.00 to 1.04, p=0.043).</p><p><strong>Conclusions: </strong>The annual incidence of TAK was similar to the previous studies from Asia, and the risk of stroke increased in TAK. Different patterns of subtype and incidence of stroke were found according to sex, although age was the only predictor.</p>","PeriodicalId":22021,"journal":{"name":"Stroke and Vascular Neurology","volume":" ","pages":"149-157"},"PeriodicalIF":5.9,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9a/f5/svn-2020-000809.PMC9067261.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39703134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful management of vaccine-induced immune thrombotic thrombocytopenia-related cerebral sinus venous thrombosis after ChAdOx1 nCov-19 vaccination.","authors":"Thomas Gattringer,&nbsp;Paul Gressenberger,&nbsp;Thomas Gary,&nbsp;Albert Wölfler,&nbsp;Markus Kneihsl,&nbsp;Reinhard Bernd Raggam","doi":"10.1136/svn-2021-001142","DOIUrl":"https://doi.org/10.1136/svn-2021-001142","url":null,"abstract":"sinus venous thrombosis (CSVT) with associated brain haemorrhage as the underlying thrombotic event. We here report our clinical expe-rience with two young women diagnosed with VITT- associated CSVT, treated with high- dose intravenous immunoglobulins (IVIGs), corti-costeroids and argatroban in the hyperacute phase, followed by dabigatran resulting in excellent outcome.","PeriodicalId":22021,"journal":{"name":"Stroke and Vascular Neurology","volume":"7 1","pages":"86-88"},"PeriodicalIF":5.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/svn-2021-001142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39169817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pertussis toxin-induced inflammatory response exacerbates intracerebral haemorrhage and ischaemic stroke in mice.","authors":"Ming Zou,&nbsp;Yan Feng,&nbsp;Yuwhen Xiu,&nbsp;Yan Li,&nbsp;Ying Zhang,&nbsp;Junwan Fan,&nbsp;Haowen Li,&nbsp;Jingli Cao,&nbsp;Wenyan He,&nbsp;Wei-Na Jin","doi":"10.1136/svn-2021-000987","DOIUrl":"https://doi.org/10.1136/svn-2021-000987","url":null,"abstract":"Background Stroke is a devastating disease, including intracerebral haemorrhage (ICH) and ischaemic stroke. Emerging evidences indicate that systemic inflammatory cascades after stroke contribute to brain damage. However, the direct effects and features of systemic inflammation on brain injury, especially comparing between ischaemic and haemorrhagic stroke, are still obscure. Methods Pertussis toxin (PT) was used to build a pro-inflammatory milieu after ICH and ischaemic stroke in mouse model. The neurodeficits, stroke lesion, immune response and blood–brain barrier (BBB) destruction were assessed. Results In ICH mouse model, PT-induced systemic inflammation exacerbated neurological deficits, and enlarged haemorrhage lesion and perihaematomal oedema. We also found promoted leucocyte infiltration and inflammatory cytokine release into the brain after PT treatment. Moreover, the integrity of the BBB was further disrupted after receiving PT. Furthermore, we demonstrated that PT enhanced brain inflammation and aggravated stroke severity in middle cerebral artery occlusion mouse model. Conclusions Our results suggest that PT increases inflammatory response that exacerbates brain injury after ICH or ischaemic stroke in mouse model.","PeriodicalId":22021,"journal":{"name":"Stroke and Vascular Neurology","volume":"7 1","pages":"29-37"},"PeriodicalIF":5.9,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f8/3b/svn-2021-000987.PMC8899681.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39268961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}