Ultrasound in Obstetrics & Gynecology最新文献

{"title":"The cerebroplacental ratio: a useful marker but should it be a screening test?","authors":"S Yagel, S M Cohen, D V Valsky","doi":"10.1002/uog.29154","DOIUrl":"10.1002/uog.29154","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"541-545"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of hypertension and diabetes in twin pregnancy using machine learning model based on characteristics at first prenatal visit: national registry study.","authors":"H J Mustafa, E Kalafat, S Prasad, M-H Heydari, R N Nunge, A Khalil","doi":"10.1002/uog.27710","DOIUrl":"10.1002/uog.27710","url":null,"abstract":"<p><strong>Objective: </strong>To develop a prediction model for hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) in twin pregnancy using characteristics obtained at the first prenatal visit.</p><p><strong>Methods: </strong>This was a cross-sectional study using national live-birth data in the USA between 2016 and 2021. The association of all prenatal candidate variables with HDP and GDM was tested on univariable and multivariable logistic regression analyses. Prediction models were built with generalized linear models using the logit link function and classification and regression tree (XGboost) machine learning algorithm. Performance was assessed with repeated 2-fold cross-validation and the area under the receiver-operating-characteristics curve (AUC) was calculated. A P value < 0.001 was considered statistically significant.</p><p><strong>Results: </strong>A total of 707 198 twin pregnancies were included in the HDP analysis and 723 882 twin pregnancies were included in the GDM analysis. The incidence of HDP and GDM increased significantly from 12.6% and 8.1%, respectively, in 2016 to 16.0% and 10.7%, respectively, in 2021. Factors associated with increased odds of HDP in twin pregnancy were maternal age < 20 years or ≥ 35 years, infertility treatment, prepregnancy diabetes mellitus, non-Hispanic Black race, overweight prepregnancy BMI, prepregnancy obesity and Medicaid as the payment source for delivery (P < 0.001 for all). Obesity Class II and III more than doubled the odds of HDP. Factors associated with increased odds of GDM in twin pregnancy were maternal age ≤ 24 years or ≥ 30 years, infertility treatment, prepregnancy hypertension, non-Hispanic Asian race, maternal birthplace outside the USA and prepregnancy obesity (P < 0.001 for all). Maternal age ≥ 30 years, non-Hispanic Asian race and obesity Class I, II and III more than doubled the odds of GDM. For both HDP and GDM, the performances of the machine learning model and logistic regression model were mostly similar, with negligible differences in the performance domains tested. The mean ± SD AUCs of the final machine learning models for HDP and GDM were 0.620 ± 0.001 and 0.671 ± 0.001, respectively.</p><p><strong>Conclusions: </strong>The incidence of HDP and GDM in twin pregnancies in the USA is increasing. The predictive accuracy of the machine learning models for HDP and GDM in twin pregnancies was similar to that of the logistic regression models. The models for HDP and GDM had modest predictive performance, were well calibrated and did not have poor fit. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"613-623"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply.","authors":"J Knez, D Jurkovic","doi":"10.1002/uog.29217","DOIUrl":"10.1002/uog.29217","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"660-661"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital heart defects during COVID-19 pandemic.","authors":"A Khalil, I Painter, V Souter","doi":"10.1002/uog.29126","DOIUrl":"10.1002/uog.29126","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"546-551"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transvaginal SlowflowHD for embryonic and fetal hearts: human cardiac development in first trimester of pregnancy.","authors":"T Hata, R Takayoshi, M Sugihara, A Koyanagi, T Miyake","doi":"10.1002/uog.29095","DOIUrl":"10.1002/uog.29095","url":null,"abstract":"","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"662-666"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incremental yield of exome sequencing over standard prenatal testing in structurally normal fetuses: systematic review and meta-analysis.","authors":"A Sotiriadis, E Demertzidou, A Ververi, E Tsakmaki, C Chatzakis, F Mone","doi":"10.1002/uog.29195","DOIUrl":"10.1002/uog.29195","url":null,"abstract":"<p><strong>Objective: </strong>To critically review the literature and synthesize evidence on the incremental yield of prenatal exome sequencing (PES) in fetuses with an apparently normal phenotype with a normal G-banded karyotype or chromosomal microarray (CMA).</p><p><strong>Methods: </strong>This systematic review and meta-analysis was conducted using a predetermined protocol and registered with PROSPERO (ID: CRD42024593349). We included observational cohort studies reporting on the incremental yield of PES in fetuses with an apparently normal phenotype and a previously normal G-banded karyotype/CMA. The risk of bias of the included studies was assessed using the Newcastle-Ottawa Scale. The pooled proportion of events was calculated using generalized linear mixed models, using the metaprop function in R version 2.15.1.</p><p><strong>Results: </strong>Four studies (1916 fetuses) were included in this systematic review and meta-analysis, of which 32 cases had a pathogenic or likely pathogenic variant. The pooled incremental yield of PES in fetuses with an apparently normal phenotype was 1.6% (95% CI, 1.0-2.6%); the majority of variants were de novo within genes associated with autosomal dominant inherited conditions (pooled incremental yield, 0.9% (95% CI, 0.5-1.7%)). Based on the expected severity of the associated disease, the pooled incremental yield was 0.5% (95% CI, 0.1-1.5%) for severe disease and 0.5% (95% CI, 0.2-1.5%) for moderate disease. There were insufficient data to conduct the predefined secondary analyses according to normality of phenotype at birth, variants of uncertain significance and expected age of disease onset.</p><p><strong>Conclusion: </strong>Pooling data from four studies, we found that 1.6% of phenotypically normal fetuses with a normal G-banded karyotype or CMA may have a pathogenic or likely pathogenic variant identified on PES, most of which occur de novo. The likelihood of a variant being associated with severe disease in such fetuses is 0.5%. However, more research is needed regarding the development of a universal classification of disease severity and the utilization of this evidence in clinical practice. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"552-559"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biparietal diameter for first-trimester pregnancy dating: multicenter cohort study.","authors":"C de Paco Matallana, V Rolle, A M Fidalgo, J Sánchez-Romero, J C Jani, P Chaveeva, J L Delgado, B Santacruz, K H Nicolaides, M M Gil","doi":"10.1002/uog.29216","DOIUrl":"10.1002/uog.29216","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the accuracy of fetal biparietal diameter (BPD) measurement in comparison with crown-rump length (CRL) measurement for pregnancy dating at 11-13 weeks' gestation.</p><p><strong>Methods: </strong>This was a retrospective multicenter cohort study performed in five maternity units in Spain, the UK, Belgium and Bulgaria between January 2011 and December 2019. We included all women who attended a routine ultrasound examination at 11 + 0 to 13 + 6 weeks who had a singleton pregnancy with a viable non-malformed fetus/neonate and ultrasound-derived measurements for both CRL and BPD, along with a comprehensive record of pregnancy outcomes. We developed a formula for pregnancy dating based on BPD using data from pregnancies conceived via in-vitro fertilization (IVF) by applying a simple linear regression. We validated this formula both internally and externally and compared it with the most commonly used formulae (Robinson's CRL-based and Kustermann's BPD-based formulae) through utilization of the Euclidean distance, relative absolute error and mean squared error. We also examined the rate of induction of labor for post-term pregnancy based on dating using each of the formulae.</p><p><strong>Results: </strong>A total of 49 492 women were included in the study, comprising 47 223 (95.4%) who conceived spontaneously and 2269 (4.6%) who conceived via IVF. In the internal validation performed using data from IVF pregnancies, our newly developed formula showed no significant difference when compared with the true gestational age calculated using conception date, with a mean difference of 0.0006 (95% CI, -0.09 to 0.09) days. In contrast, the mean difference of Kustermann's BPD-based formula was -0.31 (95% CI, -0.46 to -0.17) days and the mean difference of Robinson's CRL-based formula was -1.78 (95% CI, -1.88 to -1.68) days. In the external validation using data from spontaneously conceived pregnancies, with dating using Robinson's formula as the reference for 'true' gestational age, both our formula and Kustermann's formula resulted in underestimation of gestational age, with significant mean differences of -1.25 (95% CI, -1.28 to -1.22) days and -0.96 (95% CI, -0.98 to -0.93) days, respectively. The largest differences compared with Robinson's formula-based dating results were observed between 11 + 0 and 12 + 0 weeks. Dating the pregnancy using Robinson's formula led to 8.1% of pregnancies identified as requiring induction after 41 + 3 weeks, compared with 6.8% (P < 0.001) and 7.0% (P < 0.001) when applying our formula and Kustermann's formula, respectively.</p><p><strong>Conclusion: </strong>Pregnancy dating based on ultrasound measurement of fetal BPD between 11 + 0 and 13 + 6 weeks' gestation is a reliable alternative to dating based on fetal CRL. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"560-566"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated multivolume placental reconstruction using three-dimensional power Doppler ultrasound and infrared camera tracking.","authors":"A Xue, R Hanly, D Luichareonkit, S Thomas, T Barber, A W Welsh","doi":"10.1002/uog.27708","DOIUrl":"10.1002/uog.27708","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Placental insufficiency contributes to many obstetric pathologies, but there is no bedside clinical tool to evaluate placental perfusion. We have developed a method to acquire multiple three-dimensional (3D) power Doppler (PD) ultrasound (US) volumes of placental vasculature, with infrared camera tracking of the precise spatial location of the transducer providing global coordinates. These volumes are reconstructed automatically ('stitched') into a model of the entire placenta. The purpose of this study was to evaluate the accuracy of automated reconstruction in an US phantom and to assess the feasibility of this technique in second-to-third-trimester human placentae.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A custom-designed acrylic phantom was constructed with dimensions mimicking a third-trimester placenta, containing 12 rectangular cuboid towers of various heights submersed in tissue-mimicking solution. Multiple overlapping 3D-US volumes of this phantom were acquired using three different insonation angles and infrared camera tracking. Data were transformed into a 3D cartesian volume and stitched automatically into six 3D-US volumes, each covering the entire phantom, for each of the three different insonation angles. Reconstruction accuracy was evaluated by calculating local distance error (assessment of towers in overlapping US volumes to determine accuracy of stitching) and global distance error (subtraction of true measurements in phantom model from corresponding measurements in stitched 3D-US volumes). A single-center, cross-sectional feasibility study was then conducted in women with an uncomplicated second-to-third-trimester singleton pregnancy, with data obtained using standardized ultrasound settings. Multiple 3D PD-US and grayscale volumes of the placentae were acquired with infrared camera-tracked coordinates. Volumes were stitched to create a model of placental vasculature, and these were assessed for quality and repeatability of volume measurement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Six entire phantom datasets were reconstructed at each of three insonation angles, giving a total of 18 extended phanom datasets. A median of nine 3D-US volumes required to reconstruct the entire phantom. Twelve towers per volume were assessed on three separate occasions, generating 648 datapoints. Of these datapoints, 67.1% were perfectly aligned. The mean local distance error was 2.92 (range, 0-25.51) mm. Measurements between towers of 120 distances in each stitched 3D-US volume (2160 distances in total) differed by an average of 1.51 (range, -4.78 to 4.23) mm from the true measurements in the phantom model. In the feasibility study, 17 participants were scanned, and 49 3D-US volume datasets acquired, with 92% reconstruction success per placental volume set and at least one complete volume being obtained per participant (100% participant achievability). The median volume acquisition and reconstruction time was 10 min. Reconstructe","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"624-632"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12047681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound assessment of bladder and motor function in fetuses with open spina bifida: cohort study.","authors":"L Van der Veeken, L De Catte, A Hindryckx, F De Bie, A Sacco, K Jansen, R Devlieger, J Deprest, F M Russo","doi":"10.1002/uog.29194","DOIUrl":"10.1002/uog.29194","url":null,"abstract":"<p><strong>Objectives: </strong>Open spina bifida (OSB) is associated with lower limb and bladder dysfunction. We documented bladder function and lower limb motor function on ultrasound throughout gestation in a cohort of fetuses with OSB. The association of the prenatal findings with postnatal dysfunction was investigated, along with the impact of talipes on pre- and postnatal motor function.</p><p><strong>Methods: </strong>A prospective cross-sectional cohort study was performed including all fetuses with isolated OSB, which were assessed at the University Hospitals Leuven between July 2015 and December 2019. The anatomical level of the lesion was determined on three-dimensional ultrasound. Bladder volumes were also measured on three-dimensional ultrasound and filling-voiding changes (flow) were calculated and compared to gestational-age-matched control fetuses imaged for this study (matched 1:1). The fetal motor function level was determined on ultrasound based on joint movement of the hip, knee, ankle and toes. Postnatal bladder function was assessed by questionnaire and cystography at 1 year of age. The predictive ability of prenatal anatomical and functional levels for postnatal lower limb function was assessed. Lastly, the presence of talipes was assessed as a prognostic factor.</p><p><strong>Results: </strong>We included 122 examinations from 69 OSB fetuses. Bladder volumes were smaller in fetuses with OSB compared to controls and the difference increased with advancing gestational age. There was no association of bladder volume and urinary flow with the level of the lesion, nor was there a measurable effect of prenatal surgery on fetal bladder volume. Postnatal urinary reflux was more likely in children with a smaller bladder volume and lower urinary flow rate at 24 weeks' gestation. Lower limb motor dysfunction was more frequent at higher gestational ages. In-utero motor function was a better predictor of postnatal motor function than the anatomical level of the lesion in fetuses that underwent surgery. Fetuses with talipes performed four levels worse postnatally compared to fetuses without talipes, despite a similar anatomical level of the lesion.</p><p><strong>Conclusion: </strong>In OSB, prior to fetal surgery, bladder volume and urinary flow are already abnormal from early in gestation, independent of the level of the lesion, and may be predictive of postnatal urinary reflux. Motor function impairment can be demonstrated prenatally and is a better predictor of postnatal motor dysfunction than the prenatal anatomical level of the lesion. The presence of talipes adversely impacts postnatal motor function. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"581-588"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Middle cerebral artery velocity time integral as a predictor of fetal anemia using fetal hemoglobin Bart's disease as study model.","authors":"N Parapob, P Jatavan, S Luewan, T Tongsong","doi":"10.1002/uog.29213","DOIUrl":"10.1002/uog.29213","url":null,"abstract":"<p><strong>Objective: </strong>To assess the diagnostic performance of middle cerebral artery (MCA) velocity time integral (VTI) in predicting fetal hemoglobin (Hb) Bart's disease.</p><p><strong>Methods: </strong>This was a secondary analysis of data collected prospectively from pregnant women at risk for fetal Hb Bart's disease assessed at 17-22 weeks' gestation, receiving care at the Maternal-Fetal Medicine Unit, Chiang Mai Hospital, Thailand, between January 2008 and December 2023. Each fetus underwent prenatal measurement of MCA peak systolic velocity (PSV) and MCA-VTI. Final diagnosis of Hb Bart's disease was confirmed by Hb typing of cord blood, obtained by cordocentesis. MCA-PSV and MCA-VTI were evaluated both as absolute values and multiples of median (MoM) normalized for gestational age. Diagnostic performance of MCA-PSV and MCA-VTI for predicting fetal Hb Bart's disease was evaluated and compared using area under the receiver-operating-characteristics curve (AUC), sensitivity, specificity and positive and negative predictive values.</p><p><strong>Results: </strong>A total of 485 fetuses at risk for Hb Bart's disease (109 affected, 376 unaffected) met the inclusion criteria. Absolute MCA-VTI values were significantly higher in affected compared with unaffected fetuses (7.9 ± 1.8 vs 5.4 ± 1.3; P < 0.001) as were MoM values (1.5 ± 0.3 vs 1.0 ± 0.2; P < 0.001). The diagnostic performance of MCA-VTI was superior to that of MCA-PSV for detecting fetal anemia due to Hb Bart's disease, with AUCs of 0.877 (95% CI, 0.836-0.917) and 0.898 (95% CI, 0.857-0.938) for absolute MCA-VTI values (in cm) and MCA-VTI MoM, respectively, compared with 0.842 (95% CI, 0.795-0.889) and 0.854 (95% CI, 0.809-0.899) for absolute MCA-PSV values (in cm/s) and MCA-PSV MoM, respectively (P < 0.001).</p><p><strong>Conclusion: </strong>MCA-VTI is more accurate compared with MCA-PSV for predicting fetal Hb Bart's disease, which indirectly reflects anemia. This suggests that MCA-VTI could serve as an alternative or adjunct to MCA-PSV for detecting fetal anemia, particularly in cases of Hb Bart's disease and potentially for other etiologies. © 2025 International Society of Ultrasound in Obstetrics and Gynecology.</p>","PeriodicalId":23454,"journal":{"name":"Ultrasound in Obstetrics & Gynecology","volume":" ","pages":"597-603"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}