Bmj Military Health最新文献

{"title":"Disease and non-battle injury incidence rate trends in the US military, 2010-2021.","authors":"Karl Christian Alcover, K J Howard, E Poltavskiy, B Dao, I J Stewart, J T Howard","doi":"10.1136/military-2025-003027","DOIUrl":"https://doi.org/10.1136/military-2025-003027","url":null,"abstract":"<p><strong>Introduction: </strong>This study's purpose was to analyse disease and non-battle injury (DNBI) incidence trends in US military personnel from 2010 to 2021 to understand implications for medical readiness.</p><p><strong>Methods: </strong>A retrospective cohort of deidentified DNBI cases was developed from the person-event data environment for all military personnel between 2010 and 2021. Chronic and acute conditions were identified using the clinical classification software for categorising International Classification of Disease-9-Clinical Modification (ICD-9-CM) codes and clinical classification software refined for categorising ICD-10-CM codes. The analysis focused on incidence rates (per 10 000 person-years) using negative binomial regression analyses and trend analysis using joinpoint regression to estimate annual percent change (APC) both within the continental US (CONUS) and outside it (OCONUS).</p><p><strong>Results: </strong>Over 16.9 million person-years were analysed, including CONUS (87.5%) and OCONUS (12.5%). Acute diagnoses comprised 82% of all DNBIs, with the highest rates in musculoskeletal diseases (4494.8 per 10 000), nervous system disorders (2595.7 per 10 000) and non-battle injury (NBI) (2513.1 per 10 000). Chronic mental health disorders had the highest incidence (836 per 10 000) followed by chronic musculoskeletal diseases (661.8 per 10 000). Incidence rates for most diagnosis categories decreased. NBI rates decreased from 2010 to 2021 but most notably for acute NBI from 2018 to 2021 in CONUS (APC=-11.9%) and OCONUS (APC=-13.8%). Infectious disease incidence rates declined until 2019 and were markedly higher in 2020-2021 in CONUS (APC=37.9%) and OCONUS (APC=38.2%), mainly due to COVID-19. Chronic mental health disorder incidence decreased from 2010 to 2021 but acute incidence increased from 2014 to 2021 in both CONUS (APC=20.1%) and OCONUS (APC=19.7%). Incidence of chronic blood diseases increased steadily from 2010 to 2021 in CONUS (APC=3.8%).</p><p><strong>Conclusions: </strong>Incidence rates for most disease categories decreased from 2010 to 2021. However, increases in the incidence of acute infectious disease during the COVID-19 pandemic, acute mental health disorders and chronic blood diseases reveal growing risks to medical readiness, which may require enhanced surveillance and prevention efforts.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974576","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":"Does immobilisation improve outcomes in proximal tibial stress fractures among military recruits?","authors":"Christopher Martin, B Park, B M Wheatley","doi":"10.1136/military-2024-002923","DOIUrl":"https://doi.org/10.1136/military-2024-002923","url":null,"abstract":"<p><strong>Introduction: </strong>Proximal tibial stress fractures (PTSFs) are a significant cause of morbidity in military recruits, often requiring prolonged rehabilitation and leading to attrition from training. Despite their impact, little data exist to guide optimal treatment strategies, and most recommendations are extrapolated from diaphyseal tibial stress fractures. This study aims to describe fracture characteristics, treatment protocols and outcomes of Marine Corps recruits diagnosed with PTSFs.</p><p><strong>Methods: </strong>A retrospective review was conducted of Marine recruits at the Marine Corps Recruit Depot San Diego-an all-male training centre during the data collection period (2019-2021)-with MRI-confirmed PTSF. Patients who were initially treated non-operatively were included in this study. MRI and radiograph characteristics, age, bilateral or unilateral injury, treatment protocols (casting vs protected weight bearing) and outcomes-including return to full duty (RTFD) or separation-were evaluated. Statistical analyses included χ²testing, t-tests and logistic and linear regression modelling.</p><p><strong>Results: </strong>80 patients (105 total fractures) met inclusion criteria, with a mean age of 20 years. 25 patients had bilateral fractures. No patient initially treated non-operatively progressed to require surgery. PTSFs demonstrated a high likelihood of military separation, with over one in four eventually separating and an average time to disposition of 121 days. There were no statistically significant predictors of RTFD or ultimate disposition based on treating provider's specialty, casting or fracture characteristics. A trend towards decreased return to duty in bilateral fractures did not reach significance. Of the 21 separations, eight were directly attributable to the stress fracture.</p><p><strong>Conclusion: </strong>In Marine recruits with PTSFs, conservative management without casting is safe and effective, even in bilateral cases or those with extensive fracture morphology. Outcomes were similar regardless of treating provider specialty. Casting offered no additional benefit and may be unnecessary in most cases.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974586","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":"Threat of non-traditional agents: a new frontier in chemical weapons concerns?","authors":"Adrián Repilado-Álvarez, J A Guerra Guirao, I Cuadrado Berrocal, M T Llorente Ballesteros","doi":"10.1136/military-2025-003101","DOIUrl":"https://doi.org/10.1136/military-2025-003101","url":null,"abstract":"<p><p>The development and use of chemical and toxin-based weapons have evolved significantly over time, from early historical applications to modern incidents involving highly potent agents. Despite the establishment of international treaties such as the Chemical Weapons Convention (CWC) and the Biological and Toxin Weapons Convention (BTWC), emerging threats posed by non-traditional agents, particularly central nervous system (CNS)-acting chemicals and biotoxins, present ongoing challenges. These substances, while not individually scheduled, fall within the broader definitions of toxic chemicals and are prohibited if used for purposes inconsistent with the conventions.CNS-acting chemicals, including pharmaceutical-based agents such as fentanyl analogues and alpha-2 adrenergic agonists, raise concerns due to their incapacitating or lethal effects, potential misuse in law enforcement contexts and increasing availability via illicit markets. Biotoxins such as ricin and saxitoxin, although naturally derived, have military relevance and are subject to regulation under both the CWC and BTWC.This analysis synthesises key developments that have shaped the current threat landscape and explores the challenges these agents pose for both verification mechanisms and military medical preparedness. It highlights gaps in toxidrome identification, limitations in available countermeasures and the need for improved diagnostic capabilities, all of which are critical for mitigating the risks associated with exposure to non-traditional agents.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144974554","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":"Academic Department of Military Surgery and Trauma (ADMST): preparedness for the next conflict through collaboration in research and innovation.","authors":"John Breeze, M E R Marsden, G Mcknight, D N Naumann, P Spreadborough, C Swain, R Staruch, J Whitaker, R Rickard, L Orr, N Tai","doi":"10.1136/military-2025-003024","DOIUrl":"10.1136/military-2025-003024","url":null,"abstract":"<p><p>The UK Strategic Defence Review 2025 provides a compelling examination of the threats faced by the UK. The UK as a whole, and the Ministry of Defence in particular, must become ready for large-scale conflict operations (LSCO) and learn the lessons from Ukraine. A successful academic military surgical department should regularly re-evaluate its mission, its surgical priorities and its outputs. This paper describes the principles by which the UK Defence Medical Services' Academic Department of Military Surgery and Trauma will work to address the likely clinical realities of LSCO. Three overarching themes to departmental work are described, underpinned by a commitment to collaboration via research partnerships-both within and external to Defence-to enable the delivery of best possible outcomes as the country's armed forces rapidly pivot to the future and adapt to new threats.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884039","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":"UK military infection referral service: a review of activity 2018-2024.","authors":"Nicola Reece, M Jw Kain, L Swithenbank","doi":"10.1136/military-2025-003089","DOIUrl":"10.1136/military-2025-003089","url":null,"abstract":"","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884118","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":"Autonomous ground vehicles for MEDEVAC: capability assessment based on agent-based modelling.","authors":"Dalibor Procházka, V Šedivcová, J Melichar, A Tesař, H Schvach","doi":"10.1136/military-2024-002885","DOIUrl":"https://doi.org/10.1136/military-2024-002885","url":null,"abstract":"<p><strong>Introduction: </strong>Medical evacuation (MEDEVAC) is a crucial component of military healthcare, and the time during which evacuation of the wounded, injured and ill individuals happens is one of the most critical factors. The article focuses on the initial phase of ground evacuation from the Point of Injury to the casualty collection point (CCP). Casualty transport is the combat unit's task, triggered by a 9-liner MEDEVAC request. Two variants are considered: evacuation by means of one armoured vehicle per CCP according to the actual doctrine and potential evacuation using a fleet of autonomous unmanned vehicles.</p><p><strong>Methods: </strong>The analysis and comparison are based on data (injury time and position) obtained from computer-assisted exercises, and a simulation combining agent-based modelling and discrete events simulation methods is applied to compare two approaches.</p><p><strong>Results: </strong>The simulation results show that using distributed transport capability, represented by unmanned ground vehicles (UGVs), is more effective because it allows for prioritising casualties based on the injury category. The evacuation effectiveness is quantified in relation to the number of UGVs used.</p><p><strong>Conclusions: </strong>The use of UGVs can improve the care of the wounded, assuming the involvement of advanced technologies, including artificial intelligence. Information about the time and place of casualties is the key for decision makers to achieve the benefit, which should be ensured through potential monitoring of the physical condition of the wounded (body sensors and data transmission in case of injury).</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856795","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":"Pre-academy knee pain as a predictor of overuse knee injuries in first-year military cadets.","authors":"Jeffrey A Turner, K L Kucera, K L Cameron, G S Bullock, A W Kiefer, M C Boling, S W Marshall, D A Padua","doi":"10.1136/military-2025-003033","DOIUrl":"10.1136/military-2025-003033","url":null,"abstract":"<p><strong>Introduction: </strong>Musculoskeletal injuries, particularly overuse knee injuries, pose a significant challenge to military readiness, accounting for over 50% of medical visits and substantial healthcare costs. Military academy training presents unique physical demands, with cadets undergoing 15-20 hours of physical training weekly. This study aimed to determine whether a history of knee pain, independently or combined with other injuries, influences the rate of overuse knee injuries among first-year military cadets.</p><p><strong>Methods: </strong>5820 first-year cadets from US service academies completed baseline questionnaires assessing 6-month pre-academy injury history. Overuse knee injuries during the first academic year were identified using Defense Medical Surveillance System data. Risk ratios (RR) and incidence rate ratios (IRR) were calculated to compare injury risk and rate between cadets with different injury histories, adjusting for sex, age, academy and year.</p><p><strong>Results: </strong>The overall incidence rate was 240 overuse knee injuries per 1000 person-years. Incidence rates varied substantially by injury history-149 per 1000 among those without prior injury versus 613 per 1000 among those with prior knee pain only. Cadets with prior knee pain demonstrated significantly higher risk (RR=3.09; 95% CI 2.63 to 3.65; p<0.001) and rate (IRR=4.08; 95% CI 3.31 to 5.02; p<0.001) of overuse knee injury compared with those without prior lower extremity injury. Notably, the combination of prior knee pain with other injuries did not produce additive risk effects, suggesting anatomically specific injury history may be the primary driver of future injury risk.</p><p><strong>Conclusion: </strong>Rather than implementing resource-intensive screening methods, careful assessment of prior knee pain history provides a practical approach for identifying high-risk cadets who could benefit from targeted screening and prevention strategies during their first year of military training.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822905","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":"Effectiveness of the Rewind technique in treatment-seeking military veterans presenting with post-traumatic stress disorder in an NHS setting.","authors":"Helen Dare, N Kitchiner, G O'Connor","doi":"10.1136/military-2025-002999","DOIUrl":"https://doi.org/10.1136/military-2025-002999","url":null,"abstract":"<p><strong>Introduction: </strong>Emerging evidence supports the effectiveness of psychological reconsolidation interventions, such as reconsolidation of traumatic memories (RTM), for post-traumatic stress disorder (PTSD) symptoms in military veteran populations. The Rewind technique is hypothesised to work through memory reconsolidation, much like RTM, and has shown positive results when treating non-military populations with PTSD.To our knowledge, no peer-reviewed studies have focussed on Rewind's effectiveness in military veteran populations. We propose that Rewind may be a useful and effective treatment for UK military veterans with PTSD. Rewind may also provide a time-efficient intervention compared with alternative trauma-focussed therapies.</p><p><strong>Methods: </strong>Rewind was administered to 10 veterans in a pre-test-post-test design. Veterans completed psychometric measures for PTSD, depression, anxiety and insomnia before and after treatment (Posttraumatic Stress Disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5), Patient Health Questionnaire 9-item (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7) and Insomnia Severity Index (ISI)). Psychometric scores and treatment outcomes were analysed to indicate the treatment effectiveness of Rewind in military veterans.</p><p><strong>Results: </strong>Significant improvement was found before and after treatment for PTSD (t(9)=3.502, p=0.007), depression (t(9)=3.392, p=0.008) and insomnia (t(9)=2.709, p=0.024) with a large effect size (d>0.8). A significant reduction in anxiety symptoms was not found; however, a non-significant improvement was noted (GAD-7 pre-treatment, <i>M</i>=10.30, <i>SD</i>=5.889; post-treatment, <i>M</i>=6.60, <i>SD</i>=6.670). No veterans dropped out of treatment and over half (n=6) of the veterans required no further treatment after a mean of three Rewind sessions.</p><p><strong>Conclusions: </strong>Findings show preliminary and promising support for Rewind in the treatment of military veterans with PTSD. Rewind may also provide secondary relief for co-morbid difficulties such as depression and insomnia. Rewind shows promise as a time-efficient treatment compared with other trauma-focussed psychological interventions. Further research is recommended to provide supplementary evidence for Rewind's effectiveness in the military population. Future studies are recommended to conduct post-treatment follow-ups to monitor maintained symptom reduction.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805102","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":"Gambling-related harm as experienced by UK Armed Forces veterans and affected others: a thematic framework analysis.","authors":"Glen Dighton, S Treacy, A Hoon, S Dymond","doi":"10.1136/military-2025-003028","DOIUrl":"https://doi.org/10.1136/military-2025-003028","url":null,"abstract":"<p><strong>Introduction: </strong>Despite recognition of increased gambling vulnerability among military veterans, qualitative understanding of veterans' lived experiences of gambling harms, including impacts on family members, remains limited. This study explores the gambling histories, service-related influences, psychosocial impacts and support-seeking behaviours of UK veterans and their affected family members.</p><p><strong>Methods: </strong>Thematic framework analysis was conducted on semistructured interviews with six male veterans and three female family members recruited through social media and support settings. Participants were screened using the Problem Gambling Severity Index to confirm severity of gambling-related harm.</p><p><strong>Results: </strong>Four primary themes were identified: gambling histories and trajectories, the role of the Armed Forces in gambling behaviour, psychosocial and financial impacts, and barriers and motivations for seeking support. Veterans' gambling trajectories varied, with military life often seen to normalise gambling behaviours through accessibility, social reinforcement and stress-related coping mechanisms. Severe financial distress, relationship breakdowns, mental health issues and compromised trust characterised gambling's psychosocial impacts. Key barriers to seeking support included stigma, pride, denial and insufficient tailored services. Conversely, family interventions and personal crises were crucial motivators driving veterans towards recovery.</p><p><strong>Conclusions: </strong>This study highlights the profound and complex impacts of gambling-related harm among UK veterans and their families, emphasising military cultural factors and significant psychosocial consequences. Effective interventions must address both individual gambling behaviours and broader family dynamics. Greater availability of veteran-specific support services and stigma reduction could improve help-seeking. Future research should incorporate diverse samples, including female veterans and male family members, to enhance generalisability and intervention efficacy.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785684","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":"Casualty care in a low-resource conflict setting: injury epidemiology and management among military personnel in Burkina Faso from 2020 to 2024.","authors":"S Yves G Sanou, P S S Bingboure, F S A Boko, M Zida, Y J S Bassinga, Y A R Nacanabo, W S Karfo, L Kabore, C Leboa, J B Holcomb, H B H Wild","doi":"10.1136/military-2025-003045","DOIUrl":"https://doi.org/10.1136/military-2025-003045","url":null,"abstract":"<p><strong>Introduction: </strong>The Sahel region of Africa has been increasingly affected by terrorist groups; however, little international attention has been received. To address the lack of data on local casualty care in the Sahel, we conducted an analysis of casualties treated at a military hospital in Burkina Faso.</p><p><strong>Methods: </strong>A retrospective analysis of casualties treated at the largest military hospital in Burkina Faso between 1 January 2020 and 31 December 2024 was conducted. Study participants included military personnel and 'country defence volunteers' with injuries sustained during military and antiterrorism operations. Data were obtained from paper records, including patient charts, hospital registration, anaesthesia logs and operative reports. We analysed injury epidemiology, care processes and early outcomes, then compared these to findings from US casualties during operation enduring freedom (OEF) in Afghanistan.</p><p><strong>Results: </strong>Of 1392 casualties with conflict-related injuries managed during the study period, the majority (99.7%) were male with a mean age of 29.0 years. Less than 1% (0.2%) arrived within 1-hour postinjury, compared with 65.8% of OEF casualties. The majority (62.8%, n=874) arrived between 12 and 24 hours postinjury. Injury mechanisms included gunshot wound (67.9%, n=945), improvised explosive devices (20.9%, n=291), other explosives (5.0%, n=69) and transport incidents (5.9%, n=82). Extremities were the most common anatomical region of injury. The most common procedure was irrigation and debridement (78.7%, n=1096). Inpatient mortality was 1.9% (n=27).</p><p><strong>Conclusions: </strong>In this analysis of casualties from a low-resource conflict setting (LRCS) in Burkina Faso, we observed prolonged prehospital times, predominantly isolated soft tissue and extremity injuries, low inpatient mortality and gaps in data availability. Coordinated efforts to standardise casualty data collection in LRCS may hold the potential to improve insight into injury patterns and outcomes in similar environments as well as yield evidence-based opportunities to reduce preventable death.</p>","PeriodicalId":48485,"journal":{"name":"Bmj Military Health","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765647","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}