Transfusion Medicine最新文献

{"title":"The impact of pressure and temperature on the quality of suspended red blood cells: An ex vivo simulation study.","authors":"Chunyu Feng, Rui Fan, Haimei Ma, Huan Zhang","doi":"10.1111/tme.13141","DOIUrl":"https://doi.org/10.1111/tme.13141","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the impact of pressurisation and simultaneous warming at a combination of 50 kPa and 46°C on the quality of suspended red blood cells in an ex vivo environment.</p><p><strong>Background: </strong>During massive rapid blood transfusion, pressure and temperature-controlled blood warming devices are often used to prevent hypothermia caused by the infusion of large amounts of cold blood. If the pressure and temperature are not properly applied during this process, it can endanger the patient's life safety.</p><p><strong>Methods/materials: </strong>400 mL of human suspended red blood cells stored at 2-6°C were subjected to pressure and simultaneous warming at a combination of 50 kPa and 46°C. Changes in blood temperature and blood quality-related indicators before and after warming under pressure were detected, with the procedure repeated six times.</p><p><strong>Results: </strong>In the ex vivo simulated test environment, there were no statistically significant differences in routine blood indicators, biochemical indicators, and hemolysis rates of suspended red blood cells before and after pressure and warming transfusion at 50 kPa pressure and 46°C temperature (P>0.05). There were no significant changes in osmotic fragility after pressure and warming transfusion, and no obvious hemolysis was observed in the morphology of suspended red blood cells under an electron microscope.</p><p><strong>Conclusion: </strong>In the ex vivo simulated test environment, pressure and warming transfusion at 50 kPa pressure and 46°C temperature had no significant impact on blood quality, and the blood quality met the standards for the use of blood products.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035868","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":"Serological and genetic analysis of a B3 phenotype caused by c.259G > T in the ABO gene.","authors":"Min Zhang, Hongjun Gao, Yu Jiang, Fengxia Liu, Xisha Huan, Zhen Huang, Fen Yuan, Ping Lei","doi":"10.1111/tme.13140","DOIUrl":"https://doi.org/10.1111/tme.13140","url":null,"abstract":"<p><strong>Background: </strong>Mixed agglutination is a serological pattern in some ambiguous ABO blood type identification. This study focused on the serological and molecular genetic characteristics of a B3 phenotype induced by a c.259G > T mutation in the ABO gene.</p><p><strong>Study design and methods: </strong>Serological methods such as gel cards and tubes were used to identify the ABO blood type of the patient, with fluorescent PCR for ABO genotyping and Sanger sequencing for analysing the ABO exons. Protein 3D Structure was simulated and further analysed using SWISS-MODLE and PyMOL. Both the wild-type (VAL-87, ABO*B.01) and the mutant (p.Val87Leu) plasmids were transfected into Hela cells to assess the agglutination intensity of the transfected cells with anti-B antibodies.</p><p><strong>Results: </strong>Serological testing showed weak expression of the B antigen and mixed agglutination with anti-B antibodies. ABO genotyping indicated the presence of a B allele, but exon sequencing revealed an additional c.259G > T mutation in exon 6 based on the ABO*B.01 allele. The simulated three-dimensional structures of the proteins showed increased steric hindrance with mutations, leading to a relatively loose structure. The transfected Hela cells with the mutant (p.Val87Leu) plasmid exhibited a significantly reduced agglutination intensity with anti-B antibodies.</p><p><strong>Conclusion: </strong>Based on comprehensive serological, genetic, and simulation analyses, it is concluded that the c.259G > T mutation in exon 6 of the ABO*B.01 allele results in an amino acid change within the enzymatic active site. This alteration likely impacts protein stability and reduces B antigen expression, leading to the B3 subtype phenotype.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025293","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":"Antigen masking indirect antiglobulin test can mitigate the interference of Mezagitamab, a novel anti-CD38 antibody, in serological pre-transfusion testing.","authors":"Cora P Habicht, Clemens Schneeweiss","doi":"10.1111/tme.13139","DOIUrl":"https://doi.org/10.1111/tme.13139","url":null,"abstract":"<p><strong>Objectives: </strong>Investigation of the interference of mezagitamab in serological pre-transfusion testing and the use of DaraEx to overcome it.</p><p><strong>Background: </strong>Administration of anti-CD38 antibodies is a state-of-the-art therapy for patients diagnosed with multiple myeloma. However, treatment with the currently approved anti-CD38 antibodies regularly results in widespread agglutination of red blood cells in serological pre-transfusion testing, making the determination of irregular antibodies and timely transfusion of compatible blood a challenge. Mezagitamab, a novel monoclonal anti-CD38 antibody, is currently under clinical investigation, not only for the treatment of multiple myeloma but also for other indications such as generalised myasthenia gravis.</p><p><strong>Methods/materials: </strong>Mezagitamab or daratumumab spiked plasmas, with or without irregular antibodies, were tested in column agglutination technique cards. DaraEx was used to mitigate occurring interferences.</p><p><strong>Results: </strong>Mezagitamab interferes with the indirect antiglobulin test, with comparable titers but weaker reaction strengths than daratumumab. DaraEx, a reagent containing Fab fragments of an anti-CD38 antibody, is able to completely overcome this interference in the antigen masking indirect antiglobulin test (AMIAT). DaraEx treatment does not interfere with tested irregular antibodies.</p><p><strong>Conclusion: </strong>All novel anti-CD38 antibodies, such as mezagitamab, have the potential to interfere in serological pre-transfusion testing. While masking only one epitope, DaraEx has so far been an effective mitigation for all clinical anti-CD38 antibodies.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024924","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":"D-- phenotype in a South Indian family: A multicentric approach to workup and management.","authors":"Soumee Banerjee, Pooja D Kshirsagar, Ankit Mathur, Swati Kulkarni, T V Reddy","doi":"10.1111/tme.13137","DOIUrl":"https://doi.org/10.1111/tme.13137","url":null,"abstract":"<p><strong>Background: </strong>The Rh system is an extremely important blood group system with over 50 antigens, 5 of which (D, C, E, c and e) are considered most clinically significant. Rare Rh deficient phenotypes include D--, which is a blood group characterised by the lack of expression of C, c, E and e and exalted expression of the D antigen on the red cells due to mutations in both alleles of the RHCE gene. This is a multicentre approach to a case of the rare D-- phenotype.</p><p><strong>Case report: </strong>A 56-year-old lady with bad obstetric history presenting with severe anaemia had to be evaluated for a panreactive antibody affecting cross-matching. On identifying a D-- phenotype by serology, a thorough family study was performed on 18 of her first and second-degree relatives. Three family members were also found to be of the rare phenotype, one of whom was pregnant. This relative was counselled appropriately and provided with an overview of her phenotype for her obstetric care team. Molecular analysis by QMPSF confirmed the serological findings. This case eventually became the motivation behind an institutional \"rare donor\" registry programme.</p><p><strong>Results: </strong>Serology revealed a panreactive antibody affecting cross-matches. Her Rh phenotype was D+, C-, c-, E-, e-, K-, k+. Molecular analysis on her and three family members suggested homozygous CE-D hybrid alleles causing the D-- phenotype: RHCE-D(3-9)-CE.</p><p><strong>Conclusion: </strong>D-- is an uncommon phenotype and was found to occur in a cluster in this family. Like most difficult immunohematological cases, it mandated a multicentric and a multi-technique approach to resolve.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773357","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":"Understanding hepcidin for iron management in pregnancy.","authors":"Sarah Rosson, Sue Pavord","doi":"10.1111/tme.13125","DOIUrl":"10.1111/tme.13125","url":null,"abstract":"<p><p>Iron deficiency anaemia (IDA) poses a significant health challenge during pregnancy, affecting up to 30% of pregnant women in the UK. It has been linked to poor health outcomes for the mother, foetus, and the infant. Despite its prevalence and impact, current diagnostic and therapeutic approaches are limited. Ensuring an adequate iron status in pregnancy requires prompt investigation and treatment whilst avoiding excessive iron supplementation and its associated side effects. Hepcidin, a key regulator of iron trafficking in the body, has emerged as a promising candidate for tailoring iron supplementation to individual needs and responsiveness. However, current research on hepcidin-based approaches yields mixed findings, necessitating a comprehensive review to elucidate its potential utility in guiding iron therapy for pregnant women with IDA. This literature review seeks to synthesise existing evidence to explore the role of hepcidin in personalised iron supplementation for pregnant women with IDA and to identify avenues for future research to pave the way for improved management of IDA in pregnancy.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"109-115"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of Asian-Indian criteria for higher body mass index and preservative solutions on haemolysis of stored red blood cells: A prospective observational study.","authors":"Somnath Mukherjee, Stephy Varghese K, Satya Prakash, Debasish Mishra, Ansuman Sahu","doi":"10.1111/tme.13120","DOIUrl":"10.1111/tme.13120","url":null,"abstract":"<p><strong>Introduction: </strong>The quality of packed red blood cells (PRBC) is influenced by various factors such as the collection and processing method, storage conditions, type of bag materials used, anticoagulant properties, and donor characteristics. Studies have indicated that haemolysis in stored RBC bags is linked to male sex, older age, high haemoglobin count, and increased body mass index (BMI). The study's primary objective was to investigate whether a high BMI, as per Asian Pacific criteria among donors, is associated with an elevated haemolysis rate in stored RBC. Additionally, the study aimed to examine any protective effects of different types of preservatives added to blood bags against RBC haemolysis during storage.</p><p><strong>Methods: </strong>Stored RBCs from 100 blood donors with different BMI are analysed for haemolysis on 0, 21, and last day (35/42 days) of storage. A BMI cut-off of 23 was taken for healthy and overweight consideration in blood donors. The blood bags selected for storage were either with additive solution (SAGM) or without additive along with an anticoagulant. The association of the percentage of haemolysis with different variables like age, BMI, and Haemoglobin of the donor were analysed. The correlation between the haematocrit of the bag and haemolysis was determined.</p><p><strong>Results: </strong>This study did not find any significant increase in the percentage of haemolysis in blood bags with higher BMI on the last day of storage (p = 0.424). The haemolysis percentage was higher in bags without SAGM than in bags with an additive solution (p = 0.000). The high haematocrit of the bag has a significant positive correlation with the percentage of haemolysis (p = 0.002). Significantly higher haemolysis in CPDA-1 bags of donor RBC units of BMI >23 groups was observed (p = 0.000) compared to those stored in CPD-SAGM bags.</p><p><strong>Conclusion: </strong>Indian population for higher BMI, as per Asia Pacific cut-off criteria, did not significantly impact the haemolysis of blood bags. Stored RBCs with SAGM, especially of donors having BMI > 23, had a protective effect against haemolysis in blood bags. The percentage of haemolysis was positively correlated with the haematocrit of stored RBC in bags.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"144-150"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906924","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":"Universal new blood cell elution method with extensive phenotyping.","authors":"Lorraine Caruccio, Karen Byrne, David F Stroncek","doi":"10.1111/tme.13126","DOIUrl":"10.1111/tme.13126","url":null,"abstract":"<p><strong>Background/objectives: </strong>No erythrocyte elution method developed is uniformly successful or allows elution/phenotyping together. We previously developed an elution method using deionised formamide. We modified it to be universal for various cell types and call it modified formamide-method (Fm-method). It also preserves cells for phenotyping after elution.</p><p><strong>Materials and methods: </strong>Fm-method reagent contains deionised formamide, buffered high salt, EDTA, TE. Elution-reagent is removed by column centrifugation. Blood samples were used for development and validation. Results compared to commercial/common antibody elution/phenotyping methods.</p><p><strong>Results: </strong>Fm-method eluted antibodies, complement, other proteins, and nucleic acids and works with erythrocytes, leukocytes, other cells. It worked better than commercial kits used for elution/phenotyping with no false positives/negatives. It did not denature Kell and Lewis antigens and could be repeated as needed on samples to recover more antibodies and clean cells for phenotyping. Western blotting, PAGE and FCM demonstrated eluted proteins were not degraded and cells remained intact.</p><p><strong>Conclusion: </strong>Fm-method is excellent for elution and phenotyping and permits elution and phenotyping with one method and sample. It is useful for studies of various bound molecules and cell surface structures. It should be possible to elute various simple and complex carbohydrates as well. The Fm-method is efficient, inexpensive, scalable, uses common reagents. It should have excellent applications in various clinical, research, commercial settings.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"151-167"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alloanti-Hy in antenatal patients: A multi-case review.","authors":"S Lewis, N Kirkpatrick, A Nawrocki, L Reyland, B Jones, R Laundy, A McNeil, V Karamatic Crew, T Stutt, D Clinton, A Anbazhagan, C Harris, I Skidmore, T Bullock, M Hazell","doi":"10.1111/tme.13124","DOIUrl":"10.1111/tme.13124","url":null,"abstract":"<p><strong>Introduction: </strong>Introduction The Hy antigen is one of ten red cell antigens belonging to the Dombrock blood group system, with an antigen frequency of almost 100% in the majority of populations. Alloantibodies to high prevalence antigens cause difficulties with antibody identification and exclusion in serological investigations.</p><p><strong>Case presentation: </strong>This review describes the management of four antenatal cases where the presence of alloanti-Hy had been identified. Hy-red blood cell units may be required for the transfusion of patients with alloanti-Hy, but currently, there are no published reports of alloanti-Hy causing haemolytic disease of the fetus and newborn (HDFN). A previous case report involving the care and management of antenatal patients with alloanti-Hy antibodies indicates a lack of evidence that alloanti-Hy causes clinical HDFN.</p><p><strong>Results: </strong>All cases discussed in this review demonstrate a reduction in the strength of alloanti-Hy levels as pregnancy progressed. Signs or symptoms of HDFN were not observed with any of the pregnancies.</p><p><strong>Conclusion: </strong>Factors such as antibody levels, antigenic expression, and varying clinical responses enhance our understanding of why alloanti-Hy has not been known to cause clinical HDFN. The cases presented here aim to improve understanding of alloanti-Hy in pregnancy and how to manage such cases.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"197-202"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047893","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":"Serological investigations on penicillin-induced antibodies in the Thai population.","authors":"Piyathida Khumsuk, Oytip Nathalang, Tanaporn Choychimplee, Wiradee Sasikarn, Kamphon Intharanut","doi":"10.1111/tme.13117","DOIUrl":"10.1111/tme.13117","url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to assess the conditions for coating RBCs with penicillin and examine the anti-penicillin reactions of random Thai patients' sera against penicillin-coated RBCs and normal sera from Thai donors testing in the presence of the drug.</p><p><strong>Background: </strong>Penicillin-induced immunologic haemolytic anaemia (IHA) is reportedly related to possessing antipenicillin antibodies, immunoglobulin G (IgG), which has been identified in testing penicillin-coated red blood cells (RBCs). In addition, low titre penicillin antibodies, often IgM, are detected in donors by testing in the presence of a solution of the penicillin.</p><p><strong>Materials and methods: </strong>Penicillin-coated RBCs were produced, and antipenicillin was tested against those penicillin-coated RBCs amongst random Thai patients who had strongly positive direct antiglobulin (≥3+). Additionally, sera from Thai blood donors were tested in the presence of the penicillin. These relationships were determined by comparing the numbers of penicillin-antibody positive patients with their diagnosis, sex, age and blood type.</p><p><strong>Results: </strong>Penicillin requires a high pH to optimally adhere to RBCs that showed validated reactions with controls. Enrolment of 304 random patients, of whom 17 (5.59%) had positive antipenicillin tests using penicillin-coated RBCs. Of the 246 donor samples, 3 (1.22%) displayed positive reactivities in the presence of soluble penicillin. Furthermore, no association was discovered between the patient's characteristics and antipenicillin positivity.</p><p><strong>Conclusions: </strong>This is the first study to develop and report on the low percentage of patients' and donors' sera without IHA. Investigating suspected cases of penicillin-induced IHA requires following our suggested method to identify clinically significant antipenicillin.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"168-176"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142772570","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 unusual case of reagent interference in transfusion medicine workup: Pan reactive indirect antiglobulin test caused by commercial saline solution.","authors":"Martin Tøffner Pedersen, Helle Bach-Hansen, Kristina Fruerlund Rasmussen, Mark H Yazer, Ulrik Sprogøe","doi":"10.1111/tme.13113","DOIUrl":"10.1111/tme.13113","url":null,"abstract":"<p><strong>Background: </strong>At the regional transfusion service in the Region of Southern Denmark, serological investigations are primarily carried out using column agglutination techniques. This case study examines an unusual instance of reagent interference in pretransfusion testing using column agglutination at the Hospital of Southern Denmark, Aabenraa.</p><p><strong>Case presentation: </strong>A 72-year-old male patient presented for pretransfusion testing prior to hernia surgery. He typed as O RhD negative without discrepancies, but the antibody screen showed weakly positive reactions. Routine investigations showed discrepancies, leading to further investigations.</p><p><strong>Methods: </strong>Various serological tests were performed using in-house and commercial red test cells suspended in different suspension media and with different column agglutination cards and cassettes. Further investigations included washing of test cells, testing alternative saline solutions, varying incubation temperatures, testing without antihuman-globulin, and applying proteolytic enzymes.</p><p><strong>Results: </strong>Reactivity was present with red cells suspended in ID-CellStab (BioRad) but not in Red Cell Diluent (Quidel-Ortho). Reactivity was abolished by using trypsin-treated cells, indicating either the presence of an antibody reacting with-or unspecific agglutination depending on-a trypsin-sensitive protein, in both cases enhanced by ID-CellStab.</p><p><strong>Conclusion: </strong>This case highlights the importance of recognising reagent-dependent reactivity in serological testing. Adjustments to the suspension media resolved the incompatibility. Immunohematology laboratories should consider potential reagent interference when unexpected agglutination occurs.</p>","PeriodicalId":23306,"journal":{"name":"Transfusion Medicine","volume":" ","pages":"192-196"},"PeriodicalIF":1.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}