Journal of Minimal Access Surgery最新文献

{"title":"The effects of sympathectomy ganglion levels on late complications in the treatment of hyperhidrosis.","authors":"Osman Emre Ersin, Fazli Yanik, Yekta Altemur Karamustafaoglu, Yener Yoruk","doi":"10.4103/jmas.jmas_75_24","DOIUrl":"10.4103/jmas.jmas_75_24","url":null,"abstract":"<p><strong>Introduction: </strong>Pathologically excessive sweating in areas such as the palmar, axillary and/or plantar together with sympathetic hyperactivity that occurs independently of systemic causes is called primary hyperhidrosis. Although primary idiopathic hyperhidrosis can be seen at any age, the disease is most commonly seen in adolescents and young adults. The frequency of male and female genders is usually equal. Some medical and minimally invasive methods can be used in the treatment of primary hyperhidrosis. However, the known curative gold standard treatment method for the disease is thoracoscopic thoracic sympathectomy operation.</p><p><strong>Patients and methods: </strong>In this study, a total of 150 patients who applied to Trakya University Health Practice and Research Center, Department of Thoracic Surgery, between 15 October 2008 and 15 June 2021 and underwent thoracoscopic thoracic sympathectomy due to the diagnosis of hyperhidrosis were evaluated retrospectively. The patients were separated into two groups. Thoracoscopic thoracic sympathectomy was performed on the T2-T4 in the first group (Group I - n : 88) and on the T3-T5 sympathetic ganglions in the second group (Group II - n : 62).</p><p><strong>Results: </strong>The median age of patients included in the study was found to be 24 (20.75-28) years. Group I and Group II were similar in terms of gender characteristics, but Group II was older. Our success rate was found to be 92% ( n = 138). There was no mortality, major complication such as bleeding requiring open thoracotomy, chylothorax or Horner's syndrome in any of the patients. Minor complications were seen in the early and late period of the operation at a low rate. Our overall compensatory hyperhidrosis rate was 52% ( n = 78). Compensatory hyperhidrosis was detected more in Group I, although this was not statistically significant. We determined the overall satisfaction rate of our patients as 87.3% ( n = 133). The satisfaction rates of the patients in Group I and Group II were found to be similar.</p><p><strong>Conclusions: </strong>Thoracoscopic thoracic sympathectomy is a fast, safe and minimally invasive treatment method with a low complication rate. More than 90% success and a significant increase in psychosocial condition and professional quality of life can be achieved with this procedure. Future studies are needed to reveal the relationship between operated ganglion levels and the development of compensatory hyperhidrosis.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"175-182"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752180","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":"First ever reported case of right-sided rupture of eventration of the diaphragm: Thoraco-laparoscopic approach.","authors":"Priya Gupta, Sachin Wani, Vishakha Kalikar, Roy Patankar","doi":"10.4103/jmas.jmas_333_23","DOIUrl":"10.4103/jmas.jmas_333_23","url":null,"abstract":"<p><strong>Abstract: </strong>Diaphragmatic eventration (DE) is an abnormal condition where a portion or the entire hemidiaphragm elevates due to insufficient muscle or nerve function while maintaining its anatomical attachments. On the other hand, congenital diaphragmatic hernias occur due to the abnormal development of muscular entities of the diaphragm, resulting in the displacement of abdominal contents into the thorax. The difference between diaphragmatic hernia and eventration is important as there is no true defect in DE. Ruptured eventration of the diaphragm is a rare entity, with only three cases reported in adults in literature till date, all on the left side. We report the first case of ruptured eventration of the diaphragm on the right side, which was repaired by a combination of laparoscopy and thoracoscopy and with double-mesh placement.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"205-208"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492618","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":"Analysis of risk factors for major post-operative complications following intraperitoneal hyperthermic perfusion for pseudomyxoma peritonei: A retrospective cohort study.","authors":"Xiang Zhang, Shun-Cai Gao","doi":"10.4103/jmas.jmas_299_23","DOIUrl":"10.4103/jmas.jmas_299_23","url":null,"abstract":"<p><strong>Introduction: </strong>Pseudomyxoma peritonei (PMP) is a condition characterised by the presence of gelatinous tumour-like growth within the peritoneal cavity. Combined cytoreductive surgery and intraperitoneal chemotherapy have shown to improve the survival rate in PMP patients. However, post-operative complications such as cognitive dysfunction, respiratory insufficiency and acute renal failure are still observed. This retrospective study aims to explore the risk factors associated with major post-operative complications and specifically investigate the correlation with intraoperative hypotension.</p><p><strong>Patients and methods: </strong>This retrospective cohort study included PMP patients treated at Beijing Aerospace Center Hospital from 1 June, 2014 to 30 December, 2020. The primary outcome measures were major post-operative complications, including neurological, pulmonary, cardiovascular, surgical complications, acute hepatic injury and acute kidney injuries. The secondary outcome measures included infection, fever and deep venous thrombosis. Statistical analysis was conducted using EmpowerStats and R software.</p><p><strong>Results: </strong>A total of 782 patients were screened, and 668 patients were included in the statistical analysis. Amongst them, 234 (35.03%) individuals experienced major post-operative complications. Factors such as pre-operative American Society of Anaesthesiologists grading, age, haemoglobin and albumin levels, intraoperative mean arterial pressure, blood loss, fluid replacement volume, method of intraperitoneal hyperthermic perfusion and post-operative requirement for intensive care unit mechanical ventilation were found to be correlated with major complications.</p><p><strong>Conclusion: </strong>The identified risk factors provide valuable insights for improving clinical pathways in the management of PMP. Further prospective studies are warranted to establish the association between these factors and patient outcomes.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"112-118"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337270","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":"A novel technique to identify midline during endoscopic thyroidectomy.","authors":"Kamal Kataria, Richa Garg, Vikram Saini, Pritam Yadav, Sehaj Preet, Yashwant Virwadia, T Nelson","doi":"10.4103/jmas.jmas_341_23","DOIUrl":"10.4103/jmas.jmas_341_23","url":null,"abstract":"<p><strong>Abstract: </strong>Endoscopic thyroidectomy is a minimally invasive surgical approach that has become popular due to its cosmetic advantages and reduced post-operative discomfort. Central to the success of this procedure is the accurate identification of the midline, which becomes a challenge in endoscopic surgeries. We propose a novel method of using methylene blue, a Food and Drug Administration-approved dye, which offers the ability to clearly mark the midline, enhancing orientation and reducing the potential for injury to critical anatomical structures. Although using methylene blue has many benefits, there are drawbacks, including the requirement for intraoperative ultrasonography. Continued research and clinical experience will be critical in improving and extending its use in the field of thyroid surgery.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"214-216"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425731","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":"Initial experience of SSI Mantra robot-assisted transabdominal pre-peritoneal repair of primary ventral hernias.","authors":"Magan Mehrotra, Chukka Gautam Kumar","doi":"10.4103/jmas.jmas_344_23","DOIUrl":"10.4103/jmas.jmas_344_23","url":null,"abstract":"<p><strong>Introduction: </strong>Small and medium sized primary midline ventral hernias are best treated by pre-peritoneal mesh placement. This helps in prevention of complications related to intra-peritoneal mesh placement. The challenges we face while performing laparoscopic transabdominal pre-peritoneal (TAPP) procedure can be overcome by robot-assisted TAPP (rTAPP), and we present our initial experience with the same. We describe the surgical technique used in rTAPP using the relatively new SSI Mantra platform for primary midline ventral hernia repair and evaluate its feasibility and present the outcomes.</p><p><strong>Patients and methods: </strong>we performed rTAPP for primary midline ventral hernia repair in 10 patients from July 2023 to September 2023. Demographic patient data, hernia characteristics and peri-operative outcomes were measured.</p><p><strong>Results: </strong>A total of 10 patients underwent elective rTAPP for primary midline ventral hernia, of which 7 were male and 3 were female. The average defect size was 3.2 cm. The average operative time was 113 min. All the patients were discharged within 24-36 h after the procedure. There were no deaths. No post-operative complications such as haematoma, clinically significant seroma, deep or superficial wound infection or recurrence were noted within 30 days.</p><p><strong>Conclusion: </strong>rTAPP is a technically feasible procedure for the repair of small- and medium-sized midline ventral hernias with defect sizes up to 5 cm. SSI Mantra robotic platform provides the same benefit that other conventional robotic platforms provide at a much lesser cost. Further studies looking at the cost-benefit ratio are required to substantiate the above.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"141-146"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879704","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":"Outcomes of laparoscopic single-incision caecal pole resection for low-grade appendiceal mucinous neoplasm.","authors":"Han Deok Kwak","doi":"10.4103/jmas.jmas_113_23","DOIUrl":"10.4103/jmas.jmas_113_23","url":null,"abstract":"<p><strong>Introduction: </strong>Low-grade appendiceal mucinous neoplasm (LAMN) is a rare disease, and its clinical course varies from an incidental finding without symptoms to pseudomyxoma peritonei. Furthermore, there are few established treatment guidelines. This study was designed to confirm the outcomes in patients diagnosed with LAMN who underwent single-incision laparoscopic caecal pole resection.</p><p><strong>Patients and methods: </strong>This study was conducted on pathologically confirmed LAMNs from patients who underwent surgery at a single centre, a tertiary institution, from July 2016 to August 2022. Patients diagnosed with LAMN as a result of biopsy were included. All surgeries were performed with single-incision laparoscopic caecal pole resection by a single surgeon.</p><p><strong>Results: </strong>A total of 70 patients were included. The median age was 65.5 years and 36 (51.4%) patients were female. The baseline carcinoembryonic antigen (CEA) was 8.08 ng/mL (0.76-148.11). The mean maximum diameter was 29.4 mm (7-70) and calcification was seen in 22 cases on pre-operative computed tomography (CT). As a result of histological examination, all patients were marginally negative. The larger the tumour size, the higher the CEA was ( P = 0.011), and it was often accompanied by calcification ( P = 0.021). In addition, tumour size and CEA showed a positive partial correlation with each other ( r = 0.318, P = 0.018). The overall median follow-up period was 22.7 months (2-60). One case had suspected of recurrence on CT scan performed at 33 months following the surgery, but there were no related symptoms.</p><p><strong>Conclusion: </strong>Single-port laparoscopic caecal pole resection without margin involvement in LAMN was safe and feasible, and showed a favourable long-term outcome.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"107-111"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240105","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":"Multidetector computed tomography evaluation of normal thymus and variations with age.","authors":"Suprava Naik, Aishvarya Shri, Simran Sidhu, Yuvraj Lahre, Nerbadyswari Deep Bag, Sanjeev Kumar Bhoi, Sudipta Mohakud","doi":"10.4103/jmas.jmas_25_23","DOIUrl":"10.4103/jmas.jmas_25_23","url":null,"abstract":"<p><strong>Background: </strong>Thymus is a T-cell-producing lymphoid organ that appears prominent in the paediatric population and involutes in size with ageing. The gland shows a wide variety of appearances across different age groups. The purpose of the study is to evaluate the computed tomography (CT) appearance of thymus gland in the normal population with a focus on size, CT attenuation and fatty infiltration in different age groups.</p><p><strong>Patients and methods: </strong>This is a retrospective study done after taking approval from the Institutional Ethics Committee. Patients undergone CT scans of the thorax were identified from our database. All evaluations were done in non-contrast CT scans. Patients having underlying diseases that may have associated thymic abnormality were excluded. The appearance of thymus and the presence of fatty replacement were assessed. The size of thymus (length and thickness of right limb and left limb) and non-contrast CT Hounsfield unit (HU) value of thymic tissue were measured and compared in various age groups.</p><p><strong>Results: </strong>Four hundred and fifty patients were included, 262 (58.2%) were male. Mean age was 33.6 ± 17.1 years, range (3 months-80 years). The size of thymus was observed to decrease with increasing age. The mean age of complete fatty replacement in our study was 45 years. Complete fatty replacement was noted in all cases with an age of more than 60 years. The most common shape was arrowhead, and the most common location was pre-aortic and para-aortic location. Non-contrast CT HU value was maximum in infants and gradually decreased with advancing age.</p><p><strong>Conclusion: </strong>Even normal thymus can show varied appearance on CT which changes with the age of the patient being imaged. A comparison with normative data could help differentiate normal from abnormal glands to avoid unnecessary intervention.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"101-106"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10232052","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":"Preliminary comparative outcomes of Versius Robotic System-assisted cholecystectomy and laparoscopic cholecystectomy for benign gall bladder disease: Retrospective single-centre, single-surgeon analysis.","authors":"Muharrem Oner","doi":"10.4103/jmas.jmas_13_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_13_24","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to compare the outcomes of Versius Robotic System-assisted cholecystectomy with conventional laparoscopic cholecystectomy for benign gall bladder pathologies, focusing on the perioperative and post-operative parameters.</p><p><strong>Patients and methods: </strong>A retrospective study was conducted on patients with Versius Robotic System-assisted (Group VRS) or conventional laparoscopic cholecystectomy (Group LAP) between September 2021 and June 2023. Patient demographics, perioperative (operative time, conversion and intraoperative complications) details, post-operative pain management and complications were analysed.</p><p><strong>Results: </strong>The study included 44 and 58 patients in Groups VRS and LAP. In Group VRS, we detected significantly reduced post-operative pain (P = 0.009), lower opioid use (P = 0.009) and shorter hospital stays (P = 0.029) than in Group LAP. Total operative time was longer in Group VRS (P < 0.001). No intraoperative complications or conversions occurred in either group.</p><p><strong>Conclusion: </strong>Versius Robotic System-assisted cholecystectomy is a safe and feasible approach for benign gall bladder pathologies, offering benefits such as reduced post-operative pain and shorter hospital stays.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711793","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":"Demographic and clinical predictors of bariatric surgery patients: A retrospective cohort study.","authors":"Raghad Abdulmohsen Aljuhani, Fatma Elsayed Hassan, Zainab Jasim AlQurain, Tanveer Nidal Khan, Doaa A Turkistani, Mohammed Ahmed Alabbadi","doi":"10.4103/jmas.jmas_377_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_377_24","url":null,"abstract":"<p><strong>Introduction: </strong>The significant rise in bariatric procedures (BPs) reflects the global increase in obesity. In Saudi Arabia, obesity prevalence is notably high at 35.6%, surpassing the global average. This retrospective cohort study primarily aims to identify demographic and clinical predictors influencing BP uptake among individuals at a single healthcare centre in Jeddah, Saudi Arabia. Secondarily, it evaluates the effectiveness of BPs, particularly laparoscopic sleeve gastrectomy (LSG), in reducing body mass index (BMI) and obesity-related comorbidities.</p><p><strong>Patients and methods: </strong>Data were extracted from the hospital's registry between October 2023 and June 2024. The study population included obese adults of varying ages, genders and comorbidities who underwent bariatric surgery. However, the single-centre design limited generalisability, long-term outcome data were unavailable and contextual factors, such as socioeconomic status and health literacy, were not captured.</p><p><strong>Results: </strong>A cohort of 208 patients was analysed, 64.9% females and 34.2% males, with a mean age of 36 ± 11.2 years. The pre-operative BMI was 44.10 ± 6.2 kg/m² (P = 0.462), which decreased to 35.1 ± 6.5 kg/m² (P = 0.577) postoperatively, reflecting a mean reduction of 9.03 ± 4.9 kg/m² (20.5%) (P = 0.255). LSG was the most performed BP at 93.3%. The most prevalent obesity-related comorbidities identified were hypertension, diabetes and GIT disease including gall bladder disorders (15.9%, 13.9% and 13.5%, respectively).</p><p><strong>Conclusions: </strong>This study highlights the increasing prevalence of BP, particularly among young, predominantly female patients. LSG demonstrated substantial effectiveness, achieving a 20.5% reduction in BMI and improvement in obesity-related comorbidities. Future research could explore more patient demographics that could not be analysed in this study.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694216","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":"Robot-assisted lateral pancreaticojejunostomy in a patient with chronic pancreatitis and history of liver transplantation.","authors":"Boštjan Plešnik, Jan Grosek, Blaž Trotovšek, Aleš Tomažic, Miha Petric","doi":"10.4103/jmas.jmas_347_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_347_24","url":null,"abstract":"<p><strong>Abstract: </strong>A 52-year-old female patient with a history of liver transplantation due to alcoholic liver cirrhosis presented with persistent post-prandial pain, leading to substantial weight loss of 16 kg. The findings of contrast-enhanced computed tomography were consistent with the diagnosis of chronic pancreatitis, and endoscopic treatment provided no functional improvement. The patient was scheduled for a robot-assisted lateral pancreaticojejunostomy which was performed after initial lysis of adhesions from her prior liver transplantation. The procedure was completed safely using the robotic da Vinci Xi platform in 180 min, with an estimated blood loss of 300 mL. During the post-operative course, anaemia was noted and treated with a blood transfusion, and the patient was discharged on the post-operative day 4. The patient fully recovered without post-prandial pain and began regaining weight 1 month after the procedure. To the best of our knowledge, this is the first report of a successful robot-assisted lateral pancreaticojejunostomy following prior liver transplantation.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694143","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}