Surgical infections最新文献

{"title":"Predictive Value of Red Blood Cell Distribution Width-to-Platelet Ratio for Severity in Pyogenic Liver Abscess: A Retrospective Observational Study.","authors":"Yunxiao Lyu, Hao Wang, Zhuojun Zhong, Bin Wang","doi":"10.1089/sur.2024.068","DOIUrl":"https://doi.org/10.1089/sur.2024.068","url":null,"abstract":"<p><p><b><i>Background:</i></b> The ratio of red blood cell distribution width (RDW) to platelet ratio (RPR) may have prognostic value in several inflammation-related diseases. However, few studies have been conducted on the value of RPR for predicting the severity of pyogenic liver abscess (PLA). <b><i>Methods:</i></b> Patients receiving the diagnosis of PLA from February 2013 to December 2022 were enrolled in this retrospective study. We collected data related to baseline characteristics and laboratory results within the first 24 hours the  of admission. The receiver operating characteristic curve and the area under the curve (AUC) were used to evaluate the predictive ability of different indicators for severity in PLA. <b><i>Results:</i></b> A total of 278 patients were enrolled. For the prediction of sepsis in PLA, RPR had the highest AUC (0.83; 95% confidence interval [CI], 0.78-0.89) with a sensitivity of 0.78 and specificity of 0.82. For the prediction of septic shock, RPR also had the highest AUC (0.74; 95% CI, 0.60-0.88) with a sensitivity of 0.67 and specificity of 0.79. The best cutoff value for RPR to predict sepsis was 0.08 and to predict septic shock was 0.11. <b><i>Conclusions:</i></b> An increase in RPR level serves as a useful indicator with a predictive capacity for severity in PLA.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508398","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":"A Mendelian Randomization Study of the Connection Between Exogenous Hormones and Perianal Abscess in Pediatric Patients.","authors":"Hai Zhou, Chunli Bao, Yao Li, Guoyong Wang, Wei Zhou, Chunbao Guo","doi":"10.1089/sur.2024.229","DOIUrl":"https://doi.org/10.1089/sur.2024.229","url":null,"abstract":"<p><p><b><i>Background:</i></b> Recent years have witnessed the hypothesis that bioavailable testosterone (BT) might be closely related to the development of inflammatory diseases, especially anal abscess (AA), a common inflammatory ailment with unclear pathogenesis. Given that AA is more prevalent among males, this study investigates the causal relationship between BT and AA. <b><i>Objective:</i></b> To explore the causal link between BT and AA, a Mendelian randomization (MR) study was conducted using large-scale genomic data. <b><i>Materials and Methods:</i></b> Utilizing genomic data from the UK Biobank and IEU OpenGWAS databases, a two-sample MR analysis was executed. Twenty-six genetic variants strongly associated with BT were selected as instrumental variables (IVs) to assess their link with AA risk. Various MR methods were employed for consistency checks, including sensitivity analyses for heterogeneity and horizontal pleiotropy. <b><i>Results:</i></b> Using a combination of MR methods, we identified a significant causal relationship between BT and the risk of AA. Specifically, the MR analysis revealed that higher levels of BT were associated with an increased risk of AA. Sensitivity analyses, including heterogeneity tests and assessments for horizontal pleiotropy, confirmed the robustness of these findings. The IVs used in the analysis demonstrated a strong association with BT and showed no evidence of significant heterogeneity or horizontal pleiotropy, indicating the validity of the causal inference. <b><i>Conclusion:</i></b> This study, employing two-sample MR for the first time, confirms a causal relationship between BT levels and the risk of AA. These findings provide preliminary evidence of the causal relationship between BT and AA and may offer new insights into the pathophysiological mechanism of AA and future therapeutic strategies.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508395","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":"Bacterial Biofilm on Tissue Expander and Acellular Dermal Graft After Breast Reconstruction.","authors":"Avni Kathju, Laura Nistico, Paul Stoodley","doi":"10.1089/sur.2024.156","DOIUrl":"10.1089/sur.2024.156","url":null,"abstract":"<p><p>A 27-year-old female underwent bilateral mastectomy with left axillary dissection and had immediate breast reconstruction with textured silicone implants and acellular dermal graft (ADG) reinforcement of the inferior quadrants. The patient was maintained on oral antibiotics postoperatively and initially did well. However, she subsequently presented with fever, erythema, and tenderness in the left chest and was admitted for intravenous antibiotic therapy. Despite improvement of her symptoms, she ultimately cultured positive for <i>Staphylococcus aureus</i> and had the tissue expander and the ADG material explanted. These explanted specimens were immediately examined with confocal microscopy using Live/Dead staining under hydrated conditions for the presence of bacterial biofilms. Biofilm bacteria were clearly visualized adherent to both the tissue expander shell and also to the ADG surface. This is the first direct demonstration of viable bacteria in biofilm configuration on the surface of a tissue expander and acellular dermal graft after breast reconstruction.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"632-635"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789100","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":"<i>Granulicatella adiacens</i> Bacterial Infection After Pancreatectomy Whipple's Procedure.","authors":"Rahul Kumar Banerjee, Manisa Sahu","doi":"10.1089/sur.2024.118","DOIUrl":"10.1089/sur.2024.118","url":null,"abstract":"<p><p><b><i>Background:</i></b> <i>Granulicatella adiacens</i> inhabits the oral cavity, urogenital, and gastrointestinal tracts and is a typical commensal of human mucosal surfaces. It rarely causes disease. Identification of these gram-positive cocci can be challenging. <b><i>Case Report:</i></b> In a 58-year-old male in an oncology center, we report the first occurrence of bacterial infection caused by <i>G. adiacens</i>. After a precise diagnosis of the infection, the patient received effective treatment. <b><i>Conclusion:</i></b> Owing to a lack of sufficient diagnostic tools, <i>G. adiacens</i> may be a more notable pathogen than has been previously identified. Sensitivity testing standards are desperately needed.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"624-626"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601833","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":"Gender and Racial Differences in the Provision of Palliative Care Services Among Critically ill Necrotizing Fasciitis and Septic Shock Geriatric Patients: Analysis of a Nationwide Database in the United States.","authors":"Samia Aziz Sulaiman, Mohammed A Quazi, Amir Humza Sohail, Aman Goyal, Muhammad Altamash Jawadi, Soban Maan, Abu Baker Sheikh","doi":"10.1089/sur.2024.029","DOIUrl":"10.1089/sur.2024.029","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Necrotizing fasciitis (NF) and sepsis shock (SS) are both severe and life-threatening conditions requiring specialized care, including palliative care (PC), to optimize comfort. However, data on the utilization of PC in this population, including racial and gender differences, are limited. <b><i>Methods:</i></b> We used the National Inpatient Sample (NIS) database from 2016 to 2020 to extract data on patients with NF and SS as well as PC utilization. Chi-squared tests and multivariate linear regression models were utilized to analyze relationships between categorical and continuous variables, respectively. Multivariable logistic regression was used to determine adjusted odds ratios (aORs) and 95% confidence intervals (CI) for various outcomes among various gender and racial groups. Mann-Kendall trend test was used to assess mortality trends over time. <b><i>Results:</i></b> Among the 11,260 patients with NF and SS, 2,645 received PC whereas 8,615 did not. Female patients had significantly higher odds of receiving PC versus males (aOR: 1.42, 95% CI 1.27-1.58). No significant racial differences in PC utilization were observed. Patients receiving PC had higher odds of in-hospital mortality (aOR: 1.18, 95% CI 1.03-1.35). No significant trend in in-hospital deaths was observed over the study period. PC was associated with significantly shorter length-of-stay and lower costs. <b><i>Conclusion:</i></b> Our study provides comprehensive insights, and identifies gender differences in PC utilization in NF and SS patients. Further research must aim to refine delivery strategies and address potential differences in PC.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"586-592"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493490","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":"Minimizing the Risk of Surgical Site Infection Following Hip Fracture Operation.","authors":"Mark Maher, Alex Ward, Karen Ward, Karen Robinson, Edward Mills","doi":"10.1089/sur.2024.019","DOIUrl":"10.1089/sur.2024.019","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Hip fractures are the most common serious injury in the elderly, associated with disability, morbidity, and mortality. Surgical site infection (SSI) is a serious post-operative complication. This prospective cohort study outlines how our center made cumulative improvements in SSI incidence rates, reaching a 12-month average of 0.5%. <b><i>Methods:</i></b> All patients undergoing hip fracture operation between 2016 and 2021 were included. The primary outcome measure was confirmed SSI, according to the Public Health England definition. Results were compared with the baseline recordings by an independent SSI team in 2013. Demographic data were compared with National Hip Fracture Database records. Peri-operative infection control and wound management tactics introduced between 2014 and 2021 were collated to gain an overview care bundle. <b><i>Results:</i></b> Baseline recordings identified a 9.0% SSI rate in a three-month observation period. In our study, 3,138 hip fracture operative cases were completed between October 2016 and December 2021. There were 9 superficial and 32 deep infections identified, yielding an overall infection rate of 1.3%. However, when analyzing the 12-month average, there was consistent decline in SSI from the baseline 9.0% in 2013 to 0.5% in 2021 (p < 0.05). A peri-operative care bundle included pre-operative bleeding risk assessment. Intra-operatively, double preparation and draping is used for arthroplasty. Broad-spectrum antibiotic agents and tranexamic acid are administered. Meticulous hemostasis and watertight wound closure are observed. Anti-coagulated patients received negative pressure dressings. Post-operatively, a dedicated senior lead team provided daily inpatient review of patients, with urgent consultant review of all wound healing concerns. <b><i>Conclusion:</i></b> Patients with a hip fracture have numerous risk factors for SSI. A dedicated multi-focal tactic, adopted by a multi-disciplinary department, can yield substantial risk reduction. Each intervention is evidence based and contributes to cumulative improvement. By prioritizing infection prevention, we have minimized the need for complex infection management interventions and achieved an annual saving of £860,000 for our trust.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"574-579"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493493","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":"An in Vitro Evaluation of the 14-Day Microbial Barrier Property of Exofin High Viscosity Topical Skin Adhesive.","authors":"Chaitanya Dev Pannu","doi":"10.1089/sur.2024.036","DOIUrl":"10.1089/sur.2024.036","url":null,"abstract":"<p><p><b><i>Background:</i></b> Wound closure is a critical aspect of medical care, and the choice of closure methods plays a pivotal role in preventing infections. Traditional sutures and staples can introduce foreign material into the wound, increasing the risk of infection. Adhesives offer a potential alternative by providing a physical barrier against microorganisms. <b><i>Objective:</i></b> To assess the microbial barrier properties of Exofin High Viscosity Topical Skin Adhesive (HVTSA), a novel adhesive system, against a range of challenge organisms. <b><i>Methods:</i></b> This study, conducted by the independent research organization NAMSA (North American Science Associates, LLC), aimed to evaluate the effectiveness of Exofin HVTSA as a microbial barrier. This study was carried out by an independent research organization NAMSA. Challenge organisms, including <i>Staphylococcus aureus</i>, <i>Staphylococcus epidermidis</i>, methicillin-resistant <i>Staphylococcus aureus</i> (MRSA), <i>Pseudomonas aeruginosa</i>, <i>Escherichia coli</i>, <i>Candida albicans</i>, and <i>Aspergillus brasiliensis</i>, were used to evaluate the adhesive's effectiveness. Inocula of each organism were placed on cured Exofin HVTSA test articles and observed for 14 days. Positive and negative control plates were included to validate the effectiveness of the challenge organisms and assess the absence of contamination. <b><i>Results:</i></b> Exofin HVTSA demonstrated effective microbial barrier properties against all challenge organisms, except <i>Pseudomonas aeruginosa</i>. No growth or color change was observed for <i>Staphylococcus aureus</i>, <i>Staphylococcus epidermidis</i>, MRSA, <i>Escherichia coli</i>, <i>Candida albicans</i>, and <i>Aspergillus brasiliensis</i> over the 14-day observation period. <i>Pseudomonas aeruginosa</i> exhibited no growth, but showed a color change in two out of five replicates on day 14. <b><i>Conclusion:</i></b> Exofin HVTSA demonstrated effective microbial barrier properties for 14 days against a range of common wound pathogens, suggesting its potential as a safe and effective alternative to traditional wound closure methods. Further research is warranted to investigate its efficacy in clinical settings.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"564-573"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760909","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":"Pseudomeningocele Following Posterior Cranial Fossa Surgery Significantly Increases the Risk of Intracranial Infection: A 10-Year Retrospective Analysis.","authors":"Jing Wang, Jun-Bao Yang, Xiao-Lan Wang, Wei-Long Ding","doi":"10.1089/sur.2024.071","DOIUrl":"10.1089/sur.2024.071","url":null,"abstract":"<p><p><b><i>Background:</i></b> Posterior fossa craniotomy is commonly performed for various pathologies. However, intra-cranial infection following craniotomy causes morbidity. Pseudomeningocele is one of the main complications following posterior fossa operation. This study aimed to test the hypothesis that the risk of intra-cranial infection is increased in patients who undergo posterior fossa craniotomy with pseudomeningocele compared with those without pseudomeningocele. <b><i>Methods:</i></b> We retrospectively analyzed the data of patients undergoing posterior fossa craniotomy for the management of neurological pathologies at our institute from 2011 to 2020. A total of 308 craniotomies were included, and the primary outcome of interest was the occurrence of intra-cranial infection. Standard statistical methods were used to explore associations between several parameters, including pseudomeningocele, intra-cranial infection, and wound leak. <b><i>Results:</i></b> Of the 308 craniotomies, 41 (13.3%) developed intra-cranial infection and 59 (19.2%) involved pseudomeningocele. Of cases involving pseudomeningocele, 27 (45.8%) developed an intra-cranial infection compared with only 14 of 249 without pseudomeningocele (5.6%; p < 0.001). In the multi-variable analysis, pseudomeningocele was associated with intra-cranial infection (odds ratio [OR] 8.56; 95% confidence interval [CI] 3.145-23.299; p < 0.001) and wound leak (OR 91.339; 95% CI 10.437-799.364; p < 0.001). <b><i>Conclusion:</i></b> The findings indicate that patients undergoing posterior fossa craniotomy are at a greater risk of intra-cranial infection if there is pseudomeningocele after the operation.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"598-605"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499079","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":"Clinical Characteristics and Molecular Insights of Carbapenem-Resistant <i>Klebsiella pneumoniae</i> Isolates from Patients in Intensive Care Units.","authors":"Yun Zhou, Yinyu Mu","doi":"10.1089/sur.2024.099","DOIUrl":"10.1089/sur.2024.099","url":null,"abstract":"<p><p><b><i>Background:</i></b> Carbapenem-resistant <i>Klebsiella pneumoniae</i> (CRKP), a significant worldwide public health threat, is common in patients in intensive care units. <b><i>Methods:</i></b> A retrospective study was conducted over a period of 22 months to assess the risk factors associated with infection caused by CRKP isolates. Strain identification was performed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), and antimicrobial sensitivity was assessed using the micro broth dilution method and Kirby-Bauer test. The genes <i>bla_KPC</i>, <i>bla_OXA-48</i>, <i>bla_NDM</i>, <i>bla_VIM</i>, and <i>bla_GES</i> were amplified using polymerase chain reaction (PCR), followed by sequencing of the PCR products. The polymerase hypermucoviscosity phenotype was determined using the string test. Capsular serotypes (K1, K2) and presence of the virulence gene (<i>rmpA</i>) in positive isolates were investigated using phenotypic tests followed by PCR. <b><i>Results:</i></b> Length of hospitalization and use of carbapenems were associated with CRKP infection. CRKP isolates exhibited extensive drug resistance, but retained sensitivity to colistin and ceftazidime-avibactam (CZA). The main gene detected in 35 CRKP isolates was <i>bla_KPC-2</i>. In addition, 11 strains were positive in the string test, and two of these strains carried <i>rmpA</i>. <b><i>Conclusions:</i></b> Prolonged hospitalization and carbapenem exposure increased the risk of CRKP infection in intensive care unit (ICU) patients. The prevalence of CRKP carrying the <i>blaKPC-2</i> gene was high, and suspected hypervirulent carbapenem-resistant <i>K. pneumoniae</i> isolates were scattered.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"606-611"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591433","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 Effect of Enhanced Recovery After Surgery Protocol on Surgical Site Infections in Liver Transplantation.","authors":"S Kara, G Ozturk, Z Demir Yetis, E Korkut, N Aksungur, N Altundas, N Dogan, K Ozden","doi":"10.1089/sur.2024.046","DOIUrl":"10.1089/sur.2024.046","url":null,"abstract":"<p><p><b><i>Background:</i></b> Liver surgeries are treatment modalities that require careful pre- and postoperative follow-up for both the surgeon and the patient. Infections are the leading causes of morbidity and mortality after liver transplantation. Infections are the most frequent cause of death between 30 and 180 days after liver transplantation. We aimed to investigate the effect of the Enhanced Recovery After Surgery (ERAS) protocol on the prevention of infections in liver transplant patients. <b><i>Patients and Methods:</i></b> The study included patients who underwent liver transplantation in Ataturk University Organ Transplantation Center between 2017 and 2022. Two patient groups with and without ERAS were formed. Blood and urine cultures were collected retrospectively, and those with positive blood cultures for bacteremia were recorded as infection development. The development of infection between the two groups was statistically compared. Also, all patients' length of intensive care stay, length of hospital stay, and duration of antibiotic use were recorded. These parameters were compared between both groups. <b><i>Results:</i></b> There was a statistically significant difference between the two groups in terms of infection development (p: 0.01). There was a statistically significant difference between the two groups in terms of duration of antibiotic use and length of hospital stay (Mann-Whitney U test; p: 0.00, p: 0.04, respectively). There was no statistically significant difference between the two groups in terms of length of intensive care stay. <b><i>Conclusion:</i></b> We concluded that the introduction of an ERAS protocol was associated with fewer infections, thus shortening the duration of antibiotic therapy and length of hospital stay, although the standardization of the protocols is difficult, especially in liver transplants.</p>","PeriodicalId":22109,"journal":{"name":"Surgical infections","volume":" ","pages":"559-563"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499080","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}