Therapeutic hypothermia and temperature management最新文献

{"title":"Evaluation of Prognostic Findings in Newborns with Hypoxic Ischemic Encephalopathy: 5-Year Experience.","authors":"Ozlem Sahin, Derya Colak, Funda Yavanoglu Atay, Omer Guran, Ilke Mungan Akin","doi":"10.1089/ther.2025.0011","DOIUrl":"https://doi.org/10.1089/ther.2025.0011","url":null,"abstract":"<p><p>Hypoxic-ischemic encephalopathy (HIE) is a constellation of neurological signs as a result of hypoxia, hypercapnia, metabolic acidosis, and cerebral ischemia before birth. The aim was to evaluate risk factors, clinical and laboratory findings, and morbidity and mortality in neonates diagnosed with HIE who underwent therapeutic hypothermia (TH). Between January 2015 and December 2020, neonates diagnosed with HIE were evaluated in the neonatal intensive care unit. Risk factors, sociodemographic characteristics, degree of encephalopathy, clinical and laboratory findings, results of amplitude-integrated electroencephalography (aEEG), electroencephalography (EEG), magnetic resonance imaging (MRI) including diffusion weighted imaging (DWI) and cranial ultrasound (cUS), and mortality were retrospectively recorded. Of the 81 cases, we followed up with a diagnosis of HIE. When the patients were divided into groups and evaluated according to the Sarnat & Sarnat staging system, it was observed that 22 (27.2%) of the patients had mild HIE, 49 (60.5%) of the patients had moderate HIE, and 10 (12.3%) of the patients had severe HIE. The aEEG, EEG, DWI, and renal pathology of patients with seizures were statistically significantly higher than those of patients without seizures (<i>p</i> = 0.004, <i>p</i> = 0.002, <i>p</i> = 0.014, <i>p</i> = 0.025). MRI was performed in 66 patients within the first 7 days of life, and diffusional restriction was found in 22 of them. We found that DWI is superior to cUS in determining the severity of hypoxic injury and that renal involvement may be associated with poor neurodevelopmental outcomes. Due to the abnormal prognostic findings detected in infants with mild HIE, the existence of a standard definition of mild HIE that will determine the efficacy and reliability of therapeutic hypothermia will enable at risk infants to benefit from neuroprotective strategies.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754228","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":"Intraoperative Hypothermia Versus Normothermia in Breast Reconstruction: A Systematic Review and Meta-Analysis.","authors":"Teuku N Putra, Iqbal F Sayudo, Jesica P Sudarman, Krish Krish, Swathi Vellaichamy, Islah Nadila, Marcílio O Filho","doi":"10.1089/ther.2024.0038","DOIUrl":"10.1089/ther.2024.0038","url":null,"abstract":"<p><p>Despite advancements in breast reconstruction, the precise impact of intraoperative hypothermia on postoperative complications remains unclear. Recent literature suggests that intraoperative hypothermia is a risk factor for impaired wound healing and increases the incidence of surgical site infections. This study examines the effect of intraoperative hypothermia on postoperative outcomes in breast reconstruction. We searched PubMed, Embase, and Cochrane Library for studies comparing hypothermia with normothermia in breast reconstruction. A meta-analytical method was employed to estimate the risk of postoperative complications among patients undergoing breast reconstruction. Data synthesis employed the random-effects models, presenting the results as risk ratio (RR) with corresponding 95% confidence intervals (CIs). Statistical analysis was performed using Review Manager 5.4 (Cochrane Collaboration), and heterogeneity was assessed using I² statistics. Four studies meeting our inclusion criteria were included in the meta-analysis, comprising 871 participants. The average age and body mass index were 52.98 years and 27.76 kg/m², with a follow-up duration of 3-6 months. In our analysis, intraoperative hypothermia was associated with an increase in the incidence of wound healing complications in breast reconstruction (RR 1.68; 95% CI 1.24 to 2.27; <i>p</i> = 0.0008). Despite lower incidence of infection, hematoma, seroma, and necrosis in the hypothermia group, no significant differences were observed. Our meta-analysis assessing intraoperative hypothermia in breast reconstruction indicates that hypothermia is a significant risk factor for wound healing complications.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"10-16"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393555","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 Effectiveness of Target Temperature Management on Poor-Grade Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis.","authors":"Yang Liu, Mengyuan Xu, Pengzhao Zhang, Guang Feng","doi":"10.1089/ther.2024.0001","DOIUrl":"10.1089/ther.2024.0001","url":null,"abstract":"<p><p>The effectiveness of target temperature management (TTM) in poor-grade aneurysmal subarachnoid hemorrhage (aSAH) remains a topic of debate. In order to assess the clinical efficacy of TTM in patients with poor-grade aSAH, we conducted a systematic review and meta-analysis. This research was registered in PROSPERO (CRD42023445582) and included all relevant publications up until October 2023. We compared the TTM groups with the control groups in terms of unfavorable outcomes (modified Rankin scale [mRS] score > 3), mortality, delayed cerebral ischemia (DCI), cerebral vasospasm (CVS), and specific complications. Subgroup analyses were performed based on country, study type, follow-up time, TTM method, cooling maintenance period, and rewarming rate. Effect sizes were calculated as relative risk (RR) using random-effect or fixed-effect models. The quality of the articles was assessed using the methodological index for non-randomized studies scale. Our analysis included a total of 5 clinical studies (including 1 randomized controlled trial) and 219 patients (85 in the TTM group and 134 in the control group). Most of the studies were of moderate quality. TTM was found to be associated with a statistically significant improvement in mortality (mRS score 6) rates compared with the control group (RR = 0.61, 95% confidence interval [CI]: 0.40-0.94, <i>p</i> = 0.026). However, there was no statistically significant difference in unfavorable outcomes (mRS 4-6) between the TTM and control groups (RR = 0.94, 95% CI: 0.71-1.26, <i>p</i> = 0.702). The incidence of adverse events, including DCI, CVS, pneumonia, cardiac complications, and electrolyte imbalance, did not significantly differ between the two groups. In conclusion, our overall results suggest that TTM does not significantly reduce unfavorable outcomes in poor-grade aSAH patients. However, TTM may decrease mortality rates. Preoperative TTM may cause patients to miss the opportunity for surgery, although it temporarily protects the brain. Furthermore, the incidence of adverse events was similar between the TTM and control groups.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"1-9"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176397","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":"Comparing Hypothermic and Thermal Neutral Conditions to Induce Metabolic Suppression.","authors":"Jon C Rittenberger, Brian M Clemency, Brian Monaco, Jacqueline Schwob, Joshua T Murphey, David Hostler","doi":"10.1089/ther.2023.0085","DOIUrl":"10.1089/ther.2023.0085","url":null,"abstract":"<p><p>Suppressing metabolism in astronauts could decrease CO₂ production. It is unknown whether active cooling is required to suppress metabolism in sedated patients. We hypothesized that hypothermia would have an additive effect with dexmedetomidine on suppressing metabolism. This is a randomized crossover trial of healthy subjects receiving sedation with dexmedetomidine and exposure to a cold (20°C) or thermal neutral (31°C) environment for 3 hours. We measured heart rate, blood pressure, core temperature, resting oxygen consumption (VO₂), resting carbon dioxide production (VCO₂), and resting energy expenditure (REE) at baseline and each hour of exposure to either environment. We also evaluated components of the Defense Automated Neurobehavioral Assessment (DANA) Brief to evaluate the effect of metabolic suppression on cognition. Six subjects completed the study. Heart rate and core temperature were lower during the cold (56 bpm) condition than the thermal neutral condition (67 bpm). VO₂, VCO₂, and REE decreased between baseline and the 3-hour measurement in the cold condition (Δ = 0.9 mL/min, 56.94 mL/min, 487.9 Kcal/D, respectively). DANA simple response time increased between baseline and start of recovery in both conditions (20°C 136.9 cognitive efficiency [CE] and 31°C 87.83 CE). DANA procedural reaction time increased between baseline and start of recovery in the cold condition (220.6 CE) but not in the thermal neutral condition. DANA Go/No-Go time increased between baseline and start of recovery in both conditions (20°C 222.1 CE and 31°C 122.3 CE). Sedation and cold environments are required for metabolic suppression. Subjects experienced decrements in cognitive performance in both conditions. A significant recovery period may be required after metabolic suppression before completing mission critical tasks.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"17-22"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040385","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 Temperature Chain Management Scheme During Robot-Assisted Radical Prostatectomy.","authors":"Lanxia Pan, Fengxia Chen, Jie Hu, Yingying Zhang","doi":"10.1089/ther.2024.0020","DOIUrl":"10.1089/ther.2024.0020","url":null,"abstract":"<p><p>The study aimed to explore the effect of the temperature chain management scheme on preventing hypothermia in patients undergoing robot-assisted radical prostatectomy (RARP). The patients were randomized to receive either intraoperative warming only (control group, Group C) or the temperature chain management (experimental group, Group T). We compared the core temperature, inadvertent perioperative hypothermia (IPH) rates, the incidence of shivering, and thermal comfort between the two groups. The perioperative core temperature of the Group T was higher than that of the Group C, and the incidence of IPH, the incidence of shivering in the postanesthesia care unit (PACU), and the length of stay in PACU were lower than those of the control group. The thermal comfort of Group T scored higher than that of Group C when leaving the PACU, all above have a statistically significant difference (<i>p</i> < 0.05). The temperature chain management scheme could decrease the IPH rates and reduce postoperative complications in RARP patients. The Clinical Trials Registration number is 2023IIT034.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"47-52"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761051","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":"Acknowledgment of Reviewers 2024.","authors":"","doi":"10.1089/ther.2024.58635.revack","DOIUrl":"https://doi.org/10.1089/ther.2024.58635.revack","url":null,"abstract":"","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":"15 1","pages":"53"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568149","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":"Changes Over 7 Years in Temperature Control Treatment and Outcomes After Out-of-Hospital Cardiac Arrest: A Japanese, Multicenter Cohort Study.","authors":"Chie Tanaka, Takashi Tagami, Fumihiko Nakayama, Masamune Kuno, Nobuya Kitamura, Hideo Yasunaga, Shotaro Aso, Munekazu Takeda, Kyoko Unemoto","doi":"10.1089/ther.2023.0087","DOIUrl":"10.1089/ther.2023.0087","url":null,"abstract":"<p><p>Temperature control is the only neuroprotective intervention suggested in current international guidelines for patients with return of spontaneous circulation after cardiac arrest, but the prevalence of temperature control therapy, temperature settings, and outcomes have not been clearly reported. We aimed to investigate changes over 7 years in provision of temperature control treatment among out-of-hospital cardiac arrest (OHCA) patients in Kanto region, Japan. Data of all adult OHCA patients who survived for more than 24 hours in the prospective cohort studies, SOS-KANTO 2012 (conducted from 2012 to 2013) and SOS-KANTO 2017 (conducted from 2019 to 2021), in Japan were included. We compared the prevalence of temperature control and the proportion of mild (≥35°C) and moderate (from 32°C to 34.9°C) hypothermia between the two study groups. We also performed a Cox regression analysis to evaluate 30-day mortality adjusted by temperature control therapy (none, moderate hypothermia, or mild hypothermia), age, sex, past medical history, witnessed status, bystander cardiopulmonary resuscitation, initial rhythm, location of arrest, and dataset (SOS-KANTO 2012 or 2017). We analyzed data from 2936 patients (<i>n</i> = 1710, SOS-KANTO 2012; <i>n</i> = 1226, SOS-KANTO 2017). Use of temperature control was lower (45.3% vs. 41.4%, <i>p</i> = 0.04), moderate hypothermia was lower (<i>p</i> < 0.01), and mild hypothermia was higher (<i>p</i> < 0.01) in SOS-KANTO 2017 compared with SOS-KANTO 2012. The survival rate was significantly higher for patients with mild (<i>p</i> < 0.01) and moderate (<i>p</i> < 0.01) hypothermia compared with those who did not receive temperature control therapy. Overall, the incidence of moderate hypothermia decreased and that of mild hypothermia increased and the use of temperature control decreased between the two studies conducted 7 years apart in the Kanto area, Japan. Temperature control management might improve survival of patients with OHCA.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"23-30"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933019","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 Relationship of Perioperative Inadvertent Hypothermia with Anxiety and Comfort.","authors":"Zehra Bozkurt, Özlem Şahin Akboğa","doi":"10.1089/ther.2023.0089","DOIUrl":"10.1089/ther.2023.0089","url":null,"abstract":"<p><p>The study aimed to investigate the relationship of perioperative inadvertent hypothermia with anxiety and thermal and general comfort in surgical patients. Inadvertent perioperative hypothermia occurs after surgery and affects many patient outcomes. However, the relationship between hypothermia and anxiety has been given little attention. The research is of descriptive type. A total of 117 surgical patients who met the inclusion criteria were sampled and divided into two groups: hypothermic (<i>n</i> = 54) and normothermic (<i>n</i> = 63). Patients undergoing surgery were monitored for body temperature, systolic and diastolic blood pressure, heart rate, pain intensity, anxiety (Numeric Rating Scale [NRS] and State Anxiety Scale [SAI]), and comfort (Perianesthesia Comfort Questionnaire) levels. The groups were similar in terms of descriptive characteristics (<i>p</i> > 0.05). Among the patients undergoing surgical intervention, 46.1% were hypothermic. Compared with the normothermic group, the hypothermic group had significantly lower body temperature until the second postoperative hour, lower thermal comfort score until the third postoperative hour, and higher heart rate and anxiety (NRS) score until the first postoperative day. Furthermore, there was a significant difference between the groups in terms of pain intensity up to the first 30 minutes after surgery (<i>p</i> < 0.05). Moreover, there was no significant difference between the groups in terms of pre and postoperative day one anxiety (SAI) and Periantesthesia Comfort Scale mean scores (<i>p</i> > 0.05). The study findings showed that hypothermia affected thermal comfort up to the first 3 hours after surgery, pain intensity up to the first 30 minutes, and heart rate and anxiety (NRS) levels up to the first day.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":"31-39"},"PeriodicalIF":0.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139940845","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 Therapeutic Hypothermia on the QT Interval in Postcardiac Arrest Cases.","authors":"Aydin Nadir, Mehmet Sari","doi":"10.1089/ther.2025.0005","DOIUrl":"https://doi.org/10.1089/ther.2025.0005","url":null,"abstract":"<p><p>Postcardiac arrest (PCA) syndrome is associated with high cardiovascular morbidity and mortality. Prolongation of the QT interval can lead to life-threatening ventricular arrhythmias and sudden cardiac death. Therapeutic hypothermia (TH) is widely used to improve neurological outcomes in PCA patients, but its effects on the QT interval remain a subject of investigation. This study aimed to evaluate the impact of TH on corrected QT (QTc) intervals in PCA patients. A total of 48 patients (mean age 63.2 ± 11.3 years) who survived cardiac arrest and underwent TH were included. Standard 12-lead electrocardiograms (ECGs) and serum electrolyte levels were assessed before and after TH. The QT and QTc intervals were measured using Bazett's formula, and QT dispersion (QTd) was calculated as the difference between the maximum and minimum QT intervals. Following TH, a significant increase in RR intervals was observed (480.75 ± 91.75 ms vs. 660.43 ± 97.35 ms, <i>p</i> < 0.05). QTc intervals increased significantly from 397.13 ± 12.45 ms to 449.25 ± 21.40 ms (<i>p</i> < 0.05). Similarly, QTd increased from 55.48 ± 12.45 ms to 67.41 ± 13.42 ms (<i>p</i> < 0.05). The prolongation of the QT interval was associated with a significant decrease in serum potassium and calcium levels. In conclusion, TH leads to a significant prolongation of the QT and QTc intervals and an increase in QTd. These findings suggest that close ECG monitoring is essential in PCA patients undergoing TH, particularly in those with predisposing factors for arrhythmias.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484030","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":"Characteristics and Outcomes of Veno-Arterial Extracorporeal Membrane Oxygenation in Accidental Hypothermia: A Multicenter Study in Japan.","authors":"Tadaharu Shiozumi, Yuki Miyamoto, Sachiko Morita, Naoki Ehara, Nobuhiro Miyamae, Yohei Okada, Takaaki Jo, Yasuyuki Sumida, Nobunaga Okada, Makoto Watanabe, Masahiro Nozawa, Ayumu Tsuruoka, Yoshihiro Fujimoto, Yoshiki Okumura, Tetsuhisa Kitamura, Bon Ohta, Tasuku Matsuyama","doi":"10.1089/ther.2024.0061","DOIUrl":"https://doi.org/10.1089/ther.2024.0061","url":null,"abstract":"<p><p>Despite growing evidence supporting the efficacy of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for accidental hypothermia (AH), few studies have assessed its real-world application. We aimed to describe the use and outcomes of VA-ECMO in AH patients using data from a multicenter registry. This retrospective study included adult AH patients from the Japanese accidental hypothermia network registry (J-Point registry) between April 2011 and March 2016. We analyzed patient characteristics, in-hospital data, VA-ECMO indications, and clinical outcomes for those who received VA-ECMO. Of the 537 patients in this registry, 22 received VA-ECMO, with a median age of 80 years. Severe AH was present in 18 patients, and 10 experienced cardiac arrest (CA) on hospital arrival. VA-ECMO was indicated for CA on hospital arrival (10 patients), CA after hospital arrival (5), hemodynamic instability (5), and severe hypothermia (1), with 1 case having an unclear indication. Rewarming was successful in 18 patients, and 9 survived. Survival was higher among those with CA on hospital arrival (5/10) compared with those who developed CA after hospital arrival (1/5). This study highlights the clinical application and outcomes of VA-ECMO for AH patients using multicenter registry data. Among the 22 patients who received VA-ECMO, 9 survived. Patients with CA on hospital arrival showed better survival compared with those who developed CA after arrival, emphasizing the importance of timely VA-ECMO initiation. Further research is warranted to refine patient selection, optimize initiation timing, and evaluate long-term outcomes.</p>","PeriodicalId":22972,"journal":{"name":"Therapeutic hypothermia and temperature management","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391774","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}