Journal of Perianesthesia Nursing最新文献

{"title":"Unexpected Events That Occur in Patients on the Day of Surgery: A Single-center, Prospective Observational Study.","authors":"Ahmet Aydın, Zeynep Köylü, Mesut Öterkuş","doi":"10.1016/j.jopan.2024.08.009","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.08.009","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to investigate the reasons for case cancellations on the day of surgery and determine the rates of unexpected events and case cancellations.</p><p><strong>Design: </strong>This is a prospective, cross-sectional study conducted at a single hospital.</p><p><strong>Methods: </strong>The patients' reasons for surgical cancellation were classified as preventable or nonpreventable. Patient data were obtained in the operating room after standard anesthesia monitoring by anesthesiologists. Unexpected problems that emerged in patients and cases canceled due to these problems were recorded. We evaluated blood pressure values according to the American College of Cardiology and American Heart Association guidelines.</p><p><strong>Findings: </strong>Elective surgery was planned for a total of 4,287 patients. The incidence of an unexpected event detected on the day of surgery was 5.8% (n = 250), and the case cancellation rate was 2.16%. Examination or medical condition-related factors (n = 78, 83.9%) were the most common reason for case cancellation. Among the 250 unexpected events, patients with undiagnosed hypertension were in the majority (n = 130, 52%). Severe hypertension was observed in 30 patients (12%) who were previously diagnosed with hypertension, and the surgery was canceled in 25 (83.3%) of these (P < .001).</p><p><strong>Conclusions: </strong>Preventable causes (60.2%) were more common than nonpreventable ones among case cancellations. Our findings showed that many patients had high blood pressure and were unaware of this condition. Our study allowed referral of patients to a cardiologist to begin the follow-up process. Additionally, our study highlights the need for adequate preoperative anesthesia preparation and comprehensive nursing care.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733719","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":"Sugar Low When NPO? Patient Variables Associated With Pediatric Preoperative Hypoglycemia.","authors":"Gretchen Rogers, Jenny Beitz, Shara Griffin, Melissa Neeplo, Candace Sturm, Jiwon Lee, Lili Ding, Kelly Dunn","doi":"10.1016/j.jopan.2024.08.017","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.08.017","url":null,"abstract":"<p><strong>Purpose: </strong>To identify the demographic variables and patient factors associated with pediatric patients treated for preoperative hypoglycemia at a large urban pediatric hospital.</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Methods: </strong>Chart reviews were completed for known cases of preoperative hypoglycemia. The study team evaluated each case of hypoglycemia for the presence or absence of 10 variables including age, gender, weight percentile, fasting duration for solids and clear liquids, time of day of hypoglycemic event, American Society of Anesthesiology status, surgical service, presence or absence of preoperative bowel cleanout, presence or absence of intraoperative complications, and prior history of diabetes or hypoglycemia. When comparison data were available, a comparison was made to the hospital's general surgical population.</p><p><strong>Findings: </strong>There were no statistically significant differences found between the frequency distributions of the general surgical population and the hypoglycemic population with regard to race (P = .211), gender (P = .3139), and incidence of intraoperative complications (P < .0813). However, the hypoglycemic population was different from the general population (P < .05) in the areas of age, American Society of Anesthesiology status, history of diabetes or hypoglycemia, frequency of gastrointestinal or pulmonary procedures, and time of day of the hypoglycemic event. In addition, trends were identified in the hypoglycemia population with regard to body weight, completion of preoperative bowel cleanout, and duration of fasting. These differences and trends could indicate risk factors for preoperative hypoglycemia.</p><p><strong>Conclusions: </strong>This study identified several potential risk factors for pediatric preoperative hypoglycemia; however, the study was limited by its retrospective nature. More research is needed to confirm these risk factors and identify any others.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733709","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 Cold Vapor Prevent Postoperative Nausea and Vomiting After Laparoscopic Cholecystectomy? A Randomized Controlled Trial.","authors":"Özlem İbrahimoğlu, Betül Güven, Esra Durmayüksel, Bülent Barış Güven","doi":"10.1016/j.jopan.2024.08.010","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.08.010","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to examine the effect of cold vapor on nausea and vomiting in the early postoperative period after laparoscopic cholecystectomy.</p><p><strong>Design: </strong>Randomized controlled study.</p><p><strong>Methods: </strong>This study was carried out with 44 intervention and 44 control group patients who underwent laparoscopic cholecystectomy between May 2022 and December 2022. Cold vapor was applied to the experimental group for 15 minutes in the postanesthesia care unit (PACU). The patients were evaluated in terms of nausea and vomiting at the 0th minute and 30th minute in the PACU, and at the 2nd, 6th, 12th, and 24th hours in service after surgery.</p><p><strong>Findings: </strong>There was a significant difference between the groups in terms of nausea at the postoperative 30th minute, 2nd hour, and 6th hour. The postoperative nausea incidence and scores in the experimental group were significantly lower. There was no significant difference between the groups in terms of vomiting at all times after surgery.</p><p><strong>Conclusions: </strong>Postoperative cold vapor helps to reduce the severity of nausea but does not affect vomiting. Thus, it can be used in the control of nausea after cholecystectomy.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733705","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":"Evaluation of Postanesthesia Handoff Checklist on Patient Outcomes in an Adult Postanesthesia Care Unit.","authors":"Reed Stephen Halterman, Brittany Darnell, Chima Anukam, Elizabeth Wilkes, Shannon Broxton","doi":"10.1016/j.jopan.2024.08.008","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.08.008","url":null,"abstract":"<p><strong>Purpose: </strong>The use of handoff communication tools, such as checklists, has been shown to improve communication and decrease the omission of critical patient care information. However, the effect these tools have on patient outcomes has not been investigated. After successfully implementing a handoff checklist in an adult postanesthesia care unit, patient outcomes were retrospectively measured before and after the implementation.</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Methods: </strong>Seven hundred and ninety-one prechecklist patients in September 2017 were compared to 828 postchecklist patients in September 2018. Pain scores, oxygen saturation, and end-tidal CO₂ readings were collected for postanesthesia care unit patients in both groups.</p><p><strong>Findings: </strong>Postchecklist patients exhibited less severe pain (30.8% vs 42.4%) and fewer desaturation episodes (36.4% vs 44.8%). Time to rescue for both did not show a significant difference.</p><p><strong>Conclusions: </strong>This retrospective comparison showed an improvement in measurable patient outcomes in the immediate postoperative period after the implementation of a handoff communication tool. More research is needed to determine the direct correlation between handoff tool use and measurable patient outcomes.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711232","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":"Determination of Compassion Satisfaction and Compassion Fatigue Among Surgical Nurses.","authors":"Bahtışen Çakmak, Dilek Çilingir, Bahar Candas Altinbas","doi":"10.1016/j.jopan.2024.08.007","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.08.007","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study was to examine the level of compassion satisfaction and compassion fatigue in surgical nurses.</p><p><strong>Design: </strong>A descriptive and relationship-seeking study.</p><p><strong>Methods: </strong>The study sample consisted of 200 surgical nurses working in surgical units. Data were collected using the \"Nurse Introduction Form,\" \"Compassion Scale,\" and \"Professional Quality of Life Scale.\" The data were analyzed using IBM SPSS Statistics for Windows, Version 25.0. (Armonk, NY: IBM Corp).</p><p><strong>Findings: </strong>According to this study, surgical nurses had a high level of compassion satisfaction and a moderate level of compassion fatigue. There is a statistically significant correlation between compassion satisfaction and compassion fatigue (P = .002, r = 0.220).</p><p><strong>Conclusions: </strong>Among surgical nurses, the moderating variables that influenced levels of compassion satisfaction were gender, educational level, professional experience, and overall job satisfaction. Concurrently, age and professional experience were identified as significant factors affecting compassion fatigue.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710970","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":"Nebulized Dexmedetomidine for Sedation and Mask Acceptance in Pediatric Patients Undergoing Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Cameron Blissell, Matthew Hatch, Nathan Fox, Tito D Tubog","doi":"10.1016/j.jopan.2024.08.001","DOIUrl":"10.1016/j.jopan.2024.08.001","url":null,"abstract":"<p><strong>Purpose: </strong>Compare nebulized dexmedetomidine to other sedatives while assessing the level of sedation, mask acceptance, and parental separation anxiety in the pediatric population undergoing surgery.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>MEDLINE (PubMed), Google Scholar, CINAHL, the Cochrane Review Database, Google Scholar, and gray literature were searched for evidence. Risk ratio (RR) and standardized mean difference (SMD) were used to estimate outcomes with suitable effect models. The quality of evidence was rated using the Risk of Bias and the Grades of Recommendation, Assessment, Development, and Evaluation approach.</p><p><strong>Findings: </strong>Eight studies (n = 615) were included in the review. Over 30 minutes following premedication, nebulized dexmedetomidine yielded comparable sedation scores to other nebulized treatments (SMD, -0.09; 95% confidence interval [CI], -0.45 to 0.28; P = .64). Subgroup analyses revealed that nebulized dexmedetomidine provided more satisfactory sedation levels compared with midazolam (SMD, -0.82; 95% CI, -1.37 to -0.26; P = .004), although it did not provide a satisfactory sedation level as ketamine (SMD, 0.34; 95% CI, 0.01 to 0.67; P = .04). Furthermore, patients receiving nebulized dexmedetomidine showed higher rates of satisfactory mask acceptance (RR, 1.32; 95% CI, 1.08 to 1.59; P = .007) and favorable parental separation outcomes (RR, 1.17; 95% CI, 1.04 to 1.32; P = .01).</p><p><strong>Conclusions: </strong>Nebulized dexmedetomidine is efficacious versus nebulized midazolam but not nebulized ketamine for preprocedural sedation for pediatric patients undergoing general anesthesia. Nonetheless, it demonstrated superior results in facilitating parental separation and mask acceptance.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649304","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":"Effects of Auricular Acupressure on Postoperative Nausea and Vomiting in Patients With Gynecological Laparoscopic Surgery: A Randomized Controlled Trial.","authors":"Shu-Ju Tsai, Yu-Ying Lu, Chin-Shung Wong, Tse-Hung Huang, Sing-Ong Lee","doi":"10.1016/j.jopan.2024.08.005","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.08.005","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative nausea and vomiting (PONV) is common among females undergoing gynecological surgeries. PONV not only causes patients discomfort but also leads to serious complications, affecting their health outcomes. This study aimed to evaluate the effectiveness of applying auricular acupressure to alleviate PONV and postoperative anxiety and to improve satisfaction with anesthesia care in patients undergoing gynecological laparoscopic surgery (GLS).</p><p><strong>Design: </strong>A randomized control trial was conducted for this study.</p><p><strong>Methods: </strong>Eighty patients who received general anesthesia for GLS were recruited at a medical center in northern Taiwan and randomly assigned to the control and experimental groups. Both groups had pellets taped onto different auricular points after the surgery: the stomach (CO4), cardia (CO3), liver (CO12), occiput (AT3), shenmen (TF4), and subcortex (AT4) for the experimental group and the knee (AH4) and thoracic vertebrae (AH11) for the control group. The pellets were removed 24 hours after surgery. The severity of PONV was assessed as the primary outcome. Secondary outcomes included levels of anxiety and satisfaction with postanesthesia care.</p><p><strong>Findings: </strong>After 24 hours of follow-up, patients in the experimental group reported significantly less PONV and a higher level of satisfaction with anesthesia care compared to patients in the control group. However, the levels of postoperative anxiety between the control and experimental groups were statistically insignificant.</p><p><strong>Conclusions: </strong>The study demonstrates that the six auricular points, including CO4, CO3, CO12, AT3, TF4, and AT4, can effectively alleviate PONV and improve the quality of anesthesia care after GLS. Auricular acupressure is a nonpharmacologic treatment for PONV that takes cost and patient satisfaction into consideration.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640029","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":"Perioperative Application of Point-of-care Test for Blood Viscoelasticity: A Good Choice for Coagulation Management.","authors":"Jiazhen Dai, Lin Su","doi":"10.1016/j.jopan.2024.08.004","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.08.004","url":null,"abstract":"<p><p>Point-of-care test (POCT) of blood viscoelasticity can reflect the coagulation status of patients accurately and timely. POCT can be used to monitor the effect of preoperative antithrombotic drugs on coagulation function, which will inform the selection of appropriate surgical timing. It can also be applied to analyze the reasons of intraoperative bleeding and guide the transfusion of blood products. Also, it is useful to assess the risk of postoperative thromboembolism and hint the need for prophylactic anticoagulation. This article mainly introduces the principles and clinical application of several frequently used POCTs for blood viscoelasticity, with a focus on their role in special types of diseases in which coagulation function changes significantly, such as cardiac disease, trauma, pathological obstetrics, and liver disease. Furthermore, we describe the role of microparticle in coagulation, which is a novel potential biomarker for diagnosing thrombotic disorders and possesses potential to be applied in POCTs of blood viscoelasticity.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631061","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":"Noise in the Postanesthesia Care Unit: Identifying Potential Causes for Increased Noise Levels.","authors":"Arnaud Weynants, Piet Wyffels, Nele De Poortere, Hannah Keppler","doi":"10.1016/j.jopan.2024.08.006","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.08.006","url":null,"abstract":"<p><strong>Purpose: </strong>With increasingly complex care, monitor alarms, and high patient traffic, the postanesthesia care unit (PACU) is one of the loudest patient care areas in the hospital. High noise levels lead to worse outcomes and impede recovery. The objective of this study is to measure the sound levels in the PACU and identify potential causes for increased sound levels.</p><p><strong>Design: </strong>An observational study in the 24-unit PACU in the Ghent University Hospital was conducted.</p><p><strong>Methods: </strong>Sound levels were measured every second continuously at 3 separate locations using noise dosimeters over a period of 11 days. During the sound measurements, the patient and nurse census in the PACU was measured.</p><p><strong>Findings: </strong>The mean A weighted equivalent sound level pressure (LAeq) was 59.0 A-weighted decibel (dBA) (standard deviation 6.5), exceeded the noise levels recommended by the World Health Organization (40 dBA LAEQ). With an average LAEQ of 62.4 dBA (6.1), the morning shift is the noisiest. We evaluated the effect of patient census and nurse census on LAEQ. The overall regression was statistically significant (P < .001). Nurse census and patient census significantly predicted noise levels (P < .001).</p><p><strong>Conclusions: </strong>Noise levels in the PACU were consistently above the levels recommended by the World Health Organization. Nurse census and patient census seemed to significantly impact the mean noise levels. Our results suggest that the most important sources of ambient noise are consistently present sources such as computers, ventilation systems, air-conditioning. These factors, along with the architectural design and nurse and patient census, might play a very important role in noise control.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631059","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":"Perioperative Duloxetine in Total Joint Arthroplasty: An Umbrella Review.","authors":"Xiaomeng Tian, Wenchao Wang, Ying Xu, Xiaoling Hou","doi":"10.1016/j.jopan.2024.07.020","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.07.020","url":null,"abstract":"<p><strong>Purpose: </strong>Duloxetine, a serotonin and norepinephrine reuptake inhibitor primarily used for chronic neuropathic pain, has been debated for its efficacy in total joint arthroplasty contexts.</p><p><strong>Design: </strong>Umbrella review.</p><p><strong>Methods: </strong>A comprehensive search spanning PubMed, CINAHL, OVID, Embase, MEDLINE, CENTRAL, Google Scholar, and Cochrane, with no language restrictions up to January 2024, was conducted. Two independent reviewers performed data extraction and quality assessment. Primary outcomes focused on pain scores, with secondary outcomes including morphine consumption.</p><p><strong>Findings: </strong>This review encompasses 8 randomized controlled trials involving 740 patients and 6 meta-analyses. Moderate-certainty evidence from both individual studies and meta-analyses suggests that duloxetine administration correlates with reduced ambulation (-0.73, 95% confidence interval [CI] -0.95 to -0.51 for central sensitization; -0.36, 95% CI -0.47 to -0.25 for noncentral sensitization) and decreased rest pain scores (-0.81, 95% CI -1.07 to -0.55 for central sensitization; -0.22, 95% CI -0.36 to -0.09 for noncentral sensitization), along with lower morphine consumption (-0.52, 95% CI -0.65 to -0.38). Systematic reviews indicate a consistent trend of duloxetine reducing ambulatory (ranging from -1.45 to 0.13) and resting (ranging from -13.46 to 0.16) pain scores, as well as opioid consumption (ranging from -12.72 to -0.71).</p><p><strong>Conclusions: </strong>Despite controversies surrounding its efficacy in total joint arthroplasty, duloxetine demonstrates potential in reducing perioperative pain scores and opioid consumption, even in cases of central sensitization. Further trials with larger cohorts are necessary to strengthen the validity of these findings.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631063","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}