Supportive Care in Cancer最新文献

{"title":"Palliative care outpatient interventions to limit aggressive care at end-of-life for patients with advanced soft tissue sarcomas.","authors":"Laura Thery, Thomas Zurecki, Carole Bouleuc, Clément Bonnet, Sylvie Bonvalot, Edith Nebenzahl, Romain Seban, Stéphanie Träger, Dimitri Tzanis, Matthieu de Stampa, Sarah Watson, Grégoire Marret","doi":"10.1007/s00520-025-09455-0","DOIUrl":"https://doi.org/10.1007/s00520-025-09455-0","url":null,"abstract":"<p><strong>Purpose: </strong>Factors reducing aggressive care at the end of life (EOL) for soft tissue sarcoma (STS) are unknown. We aim to evaluate the association between outpatient palliative care (PC) interventions and aggressive care at EOL for STS patients.</p><p><strong>Methods: </strong>All deceased STS patients in our center were included retrospectively over two years. The exposure was outpatient PC, while outcomes included anticancer therapy administration, emergency room visits, intensive care unit stays, hospital and hospice admissions at EOL.</p><p><strong>Results: </strong>Among the 83 patients with STS included, most patients were female (58%), with median age [SD] of 65 [15] years, and had a locally advanced/metastatic disease (n = 55, 66%) encompassing leiomyosarcoma (n = 20, 24%) and liposarcoma (n = 17, 21%). Median PC follow-up was 3.5 months (IQR, 1.3-7.6 months). Median aggressive care [range] was 1 [0-4] criteria. Timing and occurrence of outpatient PC interventions were not correlated with EOL care aggressiveness. Univariate analysis showed that outpatient PC interventions were associated with lower rates of anticancer drug use (p = 0.001 and p = 0.02 for the last 30 and 15 days of life, respectively), emergency room visits (p = 0.003), and hospital admissions (p = 0.002) in EOL. In multivariable models, outpatient PC was associated with all aggressive care criteria, excluding admission to hospice. Day hospital was the only independent predictor significantly associated with reduced occurrence of aggressive care (p = 0.002), particularly hospital admissions (p = 0.004).</p><p><strong>Conclusion: </strong>Outpatient PC, especially day hospitals, could reduce aggressive care at EOL among STS patients. Large-scale studies are needed.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 5","pages":"389"},"PeriodicalIF":2.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative and supportive care in patients with hepatocellular carcinoma: a qualitative study on attitudes and perceptions of health professionals.","authors":"Cameron Gofton, Anna Di Bartolomeo, Shalini Wijekulasuriya, Shenghan Cai, Rose Boutros, Fiona Stafford-Bell, Kim Caldwell, Geoffrey McCaughan, Amany Zekry, Simone I Strasser, Miriam Levy, Caitlin Sheehan, Stephen Goodall, Jan Maree Davis, Linda Sheahan, Ken Liu, Sally Greenaway, Scott Davison, Thang Du Huynh, Zujaj Quadri, Yvonne A Zurynski, Meera Agar, Jacob George","doi":"10.1007/s00520-025-09403-y","DOIUrl":"https://doi.org/10.1007/s00520-025-09403-y","url":null,"abstract":"<p><strong>Background: </strong>Integration of palliative and supportive care in cancer treatment pathways is becoming standardised. While there has been significant qualitative research in oncology on palliative and supportive care integration into clinical care, there is little evidence that focusses on clinicians who manage hepatocellular carcinoma (HCC) and their perceptions on palliative and supportive care.</p><p><strong>Aim: </strong>To investigate the attitudes and perceptions regarding palliative and supportive care of healthcare professionals managing patients with HCC.</p><p><strong>Design: </strong>Qualitative study involving semi-structured individual interviews transcribed verbatim and analysed thematically.</p><p><strong>Setting/participants: </strong>A total of 25 healthcare professionals including hepatologists, gastroenterology trainees, hepatology clinical nurse consultants, social workers, and palliative care specialists providing care to patients with HCC recruited at 4 tertiary hospitals via purposive sampling.</p><p><strong>Results: </strong>The following themes emerged: (1) availability of palliative care services, (2) need for clear referral pathways and processes, (3) patients' limited understanding of palliative care, (4) recognition of benefits of palliative care, and (5) the lack of training in hepatology services for palliative care provision.</p><p><strong>Conclusion: </strong>Health professionals' perceptions of integration of palliative and supportive care in liver cancer care are hampered by multiple barriers. Opportunities to establish a more cohesive approach to care integration for patients with liver cancer have been identified.  TRIAL REGISTRATION: ACTRN12623000010695 (date of registration 9/01/2023).   What is already known about the topic? • Integration of palliative and supportive care for cancer can have profound benefits for patients' symptom burden and quality of life. • There is a lack of empirical studies examining the perspectives of health professionals who manage liver cancer on the integration of palliative and supportive care into the treatment pathways for patients. What this paper adds • This study identifies a number of barriers to the implementation of palliative and supportive care into liver cancer treatment algorithms. • The absence of sufficient evidence in clinical guidelines impairs the capacity of health professionals to improve the integration of palliative and supportive care for liver cancer patients. Implications for practice, theory, or policy. • As liver cancer prevalence increases, further effort is required to develop appropriate evidence-based clinical guidelines and referral pathways to support the integration of palliative and supportive care within existing liver cancer services.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 5","pages":"384"},"PeriodicalIF":2.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between severe oral mucositis after chemotherapy and acute lung injury in patients with hematological malignancies.","authors":"Jon Brandon Mullholand, Jeffrey Horn, Alexis Anderson, Andry Van de Louw","doi":"10.1007/s00520-025-09441-6","DOIUrl":"https://doi.org/10.1007/s00520-025-09441-6","url":null,"abstract":"","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 5","pages":"385"},"PeriodicalIF":2.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient coaching for deep inspiration breath hold decreases set-up duration and left anterior descending artery dose for left-sided breast cancer radiotherapy.","authors":"Aysegul Ucuncu Kefeli, Umut Diremsizoglu, Sevda Erdogan, Aysegul Unal Karabey, Aykut Oguz Konuk, Berna Tirpanci, Maksut Gorkem Aksu, Emine Binnaz Sarper","doi":"10.1007/s00520-025-09446-1","DOIUrl":"https://doi.org/10.1007/s00520-025-09446-1","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose is to show the impact of patient coaching and home practice using the deep inspiration breath hold (DIBH) technique on radiation treatment set-up times and cardiac at-risk doses.</p><p><strong>Methods: </strong>The study involved patients who received tangential field radiotherapy using the DIBH technique for treating left breast cancer. Patients were divided into two groups: the first group consisted of those who received coaching from an oncology nurse and were given an instruction sheet at least 1 week before the computed tomography (CT) simulation. The second group consisted of those who were only taught how to hold their breath by the radiation technician on the simulation day and without further education. During treatment, the patients were monitored using the Varian RPM™ respiratory gating system, and 2D kV orthogonal imaging was performed daily. The setup duration of each patient was noted and compared between treatment groups. For each patient, the dose-volume histograms (DVHs) of the heart, LAD (left anterior descending artery), were calculated and compared for both coached DIBH (cDIBH) and non-coached DIBH (ncDIBH).</p><p><strong>Results: </strong>Thirty-six coached and 28 non-coached patients were identified. Compared with ncDIBH, coached patients were older (55.5 versus 46.5, p = 0.003) and had a significantly higher BMI (body mass index) (29.95 versus 26.32 kg/m², p = 0.006). Nevertheless, in more than half of the treatment fractions, the set-up duration was detected to be statistically longer in the ncDIBH group than in the cDIBH group. Additionally, the LAD max dose was significantly lower in the cDIBH group (36.5 versus 29.5, p = 0.02).</p><p><strong>Conclusion: </strong>Coaching at least 1 week before the simulation with an instruction sheet decreased the set-up duration, and the cardiac LAD max dose should be further decreased by this method.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 5","pages":"387"},"PeriodicalIF":2.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a breast reconstruction-specific computational model to predict shoulder function in breast cancer survivors.","authors":"Joshua Pataky, Camille L Graves, Jared Heitzenrater, Maxime Caru, Meghan E Vidt","doi":"10.1007/s00520-025-09454-1","DOIUrl":"https://doi.org/10.1007/s00520-025-09454-1","url":null,"abstract":"<p><strong>Purpose: </strong>Mastectomy and reconstruction are treatment components for many breast cancer patients, resulting in long-term shoulder dysfunction. Computational models specific to surgical approach would enable study of underlying mechanisms of shoulder dysfunction, but none exist. Our objectives were as follows: (1) develop and validate models representing lumpectomy, implant-based, and autologous flap-based reconstruction; and (2) determine how muscle contribution to hand acceleration during functional movements differs across models.</p><p><strong>Methods: </strong>The upper limb model in OpenSim was scaled to force-generating properties and anthropometry of adult females. A 405-cc wrapping surface was placed beneath the pectoralis major muscle path representing subpectoral implant placement. For model validation, shoulder moment was predicted in five postures, with an external load applied equal to mean strength measured from a breast cancer patient cohort. Induced acceleration analysis was used to identify primary muscle contributors to hand acceleration during functional movements.</p><p><strong>Results: </strong>Following model development, pectoralis major moment arm was reduced in the implant model compared to lumpectomy and flap models. Predicted shoulder moments fell within 1 standard deviation of experimental moments (i.e., external rotation: lumpectomy model, 15.1Nm; implant model, 14.1Nm; flap model, 17.5Nm; experimentally measured, 14.1Nm ± 5.4Nm; 13.0Nm ± 3.6Nm; 15.5Nm ± 5.3Nm, respectively), except horizontal abduction (all groups) and elevation (lumpectomy group), providing validation. Large shoulder muscles, including deltoid, infraspinatus, and subscapularis, were the largest contributors to hand acceleration. Pectoralis major was also identified, possibly relating to post-surgical functional deficits.</p><p><strong>Conclusion: </strong>This work identified muscle moment arm changes for implant-based reconstruction. These models can be used to predict functional outcomes of differing reconstruction surgeries.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 5","pages":"390"},"PeriodicalIF":2.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exercise and cancer-related lymphedema in the lower limbs-a randomized cross-over trial on high-intensity interval training (HIIT) with and without compression garments.","authors":"Merete Celano Wittenkamp, Carsten Bogh Juhl, Bo Zerahn, Anders Vinther","doi":"10.1007/s00520-025-09458-x","DOIUrl":"https://doi.org/10.1007/s00520-025-09458-x","url":null,"abstract":"<p><strong>Purpose: </strong>The aim was to evaluate the safety and possibility of performing high-intensity interval training (HIIT) on a stationary bike for participants with cancer-related lower limb lymphedema (LLL) with and without compression garments in a cross-over design.</p><p><strong>Methods: </strong>Twenty-one participants with LLL were randomized to two sessions of HIIT on a stationary bike, one with and one without compression garments. The sessions were separated by a seven-day washout period. The trial was carried out in a hospital setting from September to November 2018. The acceptability and safety of the intervention were assessed. The safety was evaluated as adverse events and immediate and 24-h changes in self-reported symptoms (pain, heaviness, and tension). Additionally, recruitment, completion rate, and post-exercise changes in LLL were assessed by circumferential measurements of the legs, dual energy X-ray absorptiometry (DXA), and bioimpedance spectroscopy (BIS), respectively.</p><p><strong>Results: </strong>Twenty-one out of 35 (60%) eligible patients were included, and 19 (90%) patients completed both exercise sessions. Acceptability was high, and there were no adverse events. There was no clinically relevant difference between performing exercise with and without compression in self-reported symptoms or in limb volume. Small statistically significant differences in soft tissue mass (164.2 g corresponding to 1.4%) and extracellular fluid (L-Dex range < 5 units) were observed with and without compression, respectively, both favoring exercise with compression.</p><p><strong>Conclusion: </strong>HIIT on a stationary bike was acceptable for patients with LLL and seemed safe regardless of the use of compression garments.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov registration (NCT03653819).</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 5","pages":"391"},"PeriodicalIF":2.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: \"Association between chemotherapy and the risk of developing breast cancer-related lymphedema: a nationwide retrospective cohort study\".","authors":"Benil Nesli Ata, Sibel Eyıgor","doi":"10.1007/s00520-025-09449-y","DOIUrl":"https://doi.org/10.1007/s00520-025-09449-y","url":null,"abstract":"","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 5","pages":"381"},"PeriodicalIF":2.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mediating role of attribution style between psychological predictors and resilience in women newly diagnosed with breast cancer: a cross-sectional study.","authors":"Kaina Zhou, Fan Ning, Wen Wang, Fang Zhao","doi":"10.1007/s00520-025-09457-y","DOIUrl":"https://doi.org/10.1007/s00520-025-09457-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined how attribution style mediates the relationship between psychological predictors and resilience in recently diagnosed women with breast cancer.</p><p><strong>Methods: </strong>In total, 287 patients participated in this cross-sectional study. Pearson's correlation coefficient was used to identify the relationships between the above-mentioned variables. Multiple linear regression was utilized to examine the psychological factors that predicted resilience. Structural equation modeling (SEM) was applied to identify the mediating effects of attribution style on the relationship between psychological predictors and resilience.</p><p><strong>Results: </strong>Resilience was positively correlated with attribution style (r = 0.63), life attitude (r = 0.67), and confrontation coping (r = 0.56) and negatively correlated with resignation coping (r = -0.60). The predictors of resilience were life attitude (B = 0.26; 95% confidence interval [CI]: 0.20, 0.32; p < 0.001), attribution style (1.04 [0.53, 1.54], p < 0.001), confrontation coping (0.25 [0.09, 0.41], p = 0.003), and resignation coping (-0.26 [-0.48, -0.03], p = 0.026). The three SEM models consistently demonstrated significant direct, indirect, and total effects of life attitude and coping style (confrontation or resignation) on resilience. Attribution style played a significant mediating role in life attitude, coping style (confrontation or resignation), and resilience.</p><p><strong>Conclusion: </strong>Attribution style was found to be a key mediator linking life attitude, coping style, and resilience. Interventions aimed at adjusting attribution style should be developed by considering the positive influences of life attitude and coping style on resilience in women newly diagnosed with breast cancer.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 5","pages":"382"},"PeriodicalIF":2.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I had no idea what to expect\": adolescent and young adults with cancer identify opportunities for patient-centered anticipatory guidance through narrative writing.","authors":"Trisha K Paul, Patti Waggener, Elizabeth T Bartholomew, Ryan N James, Rebecca England, Drew S Lubber, Erica C Kaye","doi":"10.1007/s00520-025-09430-9","DOIUrl":"https://doi.org/10.1007/s00520-025-09430-9","url":null,"abstract":"<p><p>Adolescents and young adults (AYAs) have unique experiences with cancer, yet little patient-centered anticipatory guidance exists specifically by AYAs and for AYAs. In the ChronCan study, we analyzed writing narratives generated by AYA participants undergoing cancer treatment to gain insights into how AYA perspectives can inform patient-centered care. Rapid qualitative analysis was used to organize and synthesize narrative content for efficient turnaround of data to guide future intervention implementation. Analysis generated two clinically relevant themes across AYA narratives: 1) AYAs identified specific aspects of the cancer journey that surprised or overwhelmed them, and 2) AYAs shared advice to help support and guide other AYA patients with newly diagnosed cancer. Both themes, interconnected by an awareness of \"what I wish I had known,\" comprised 4 overlapping subthemes related to 1) duration and intensity of treatment, 2) mental and emotional toll of treatment, 3) pervasive social impact of illness, and 4) opportunities for self-discovery. Synthesis of these insights informed development of a patient-centered anticipatory guidance framework to leverage AYA patients' expertise and wisdom for the benefit of other AYAs with cancer.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 5","pages":"380"},"PeriodicalIF":2.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamics in distress and quality of life in patients undergoing radiation therapy: a prospective cohort study.","authors":"Hana Park, Danbee Kang, Tae Hoon Lee, Dongryul Oh","doi":"10.1007/s00520-025-09371-3","DOIUrl":"https://doi.org/10.1007/s00520-025-09371-3","url":null,"abstract":"<p><strong>Purpose: </strong>This study used a mobile-based assessment tool to evaluate the dynamics of distress and quality of life (QoL) in patients with esophageal, head and neck, and rectal cancers undergoing radiation therapy (RT).</p><p><strong>Methods: </strong>A prospective cohort study was conducted between November 2022 and July 2023 and included 100 patients who had completed assessments at pre-RT, weeks 2, 4, and 6 of RT, and 1 month post-treatment. The National Comprehensive Cancer Network Distress Thermometer and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire were used.</p><p><strong>Results: </strong>All patients showed a 100% response rate to the mobile-based assessment at pre-RT, week 6, and post-treatment, with a 95% response rate at weeks 2 and 4 of RT. Of the 100 patients, 33% experienced marked distress pre-RT, with distress levels peaking at 67% at weeks 2 and 4. More than 50% of the patients reported experiencing sleep disturbance, fatigue, worry, or anxiety post-treatment. Their QoL dropped significantly during treatment from levels in weeks 2 and 4 and returned to pre-treatment levels post-RT. Higher distress was consistently correlated with poorer QoL. Emotional and physical issues such as pain and sleep disturbance were significantly associated with poor QoL pre- and post-RT.</p><p><strong>Conclusion: </strong>RT was associated with increased distress and a temporary reduction in QoL. Key factors including sleep problems, fatigue, and emotional distress require targeted interventions to improve patient outcomes. Mobile technology use has proven effective in tracking distress and QoL in patients with cancer undergoing RT.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 5","pages":"379"},"PeriodicalIF":2.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11996948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}