Brazilian Journal of Otorhinolaryngology最新文献

{"title":"Evaluation of clinical outcomes after partial horizontal laryngectomy","authors":"Daniel Abreu Rocha ,&nbsp;Gustavo Fernandes de Alvarenga ,&nbsp;Daniel Marin Ramos ,&nbsp;Leandro Luongo de Matos ,&nbsp;Rogerio Aparecido Dedivitis ,&nbsp;Marco Aurélio Vamondes Kulcsar ,&nbsp;Claudio Roberto Cernea","doi":"10.1016/j.bjorl.2025.101614","DOIUrl":"10.1016/j.bjorl.2025.101614","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate the oncological and functional outcomes of patients submitted to HPL for the treatment of LSCC.</div></div><div><h3>Methods</h3><div>A retrospective descriptive study of patients submitted to HPL, performed at a cancer referral center, between January 2011 and December 2017.</div></div><div><h3>Results</h3><div>We evaluated 37 patients. The major pathological staging of the primary tumor was pT3 (35.1%), followed by pT2 (32.4%). Five patients required adjuvant radiotherapy; 62.2% of the patients were decannulated by the end of the treatment; 10.8% weren’t decannulated; 8.1% underwent a retracheostomy, and 18.9% had total laryngectomy. From the patients submitted to total laryngectomy, 3 cases were due to rehabilitation failure, 2 due to recurrence and 2 cases due to postoperative suture dehiscence. About 89% of the patients resumed oral feeding following the procedure; 86.4% didn’t present disease recurrence; 31 patients survived without disease; 3 died from disease-related causes, and 3 from unrelated causes.</div></div><div><h3>Conclusion</h3><div>HPL is an alternative procedure to total laryngectomy, presenting adequate rates of local control and overall survival while also maintaining laryngeal function. The main challenge to HPL remains achieving an ideal selection of patients.</div></div><div><h3>Level of evidence</h3><div>Level IV.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 ","pages":"Article 101614"},"PeriodicalIF":1.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169770","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":"Comparative analysis between the gold standard titration method and a mathematical formula to predict CPAP pressure","authors":"Cíntia Felicio Adriano Rosa,&nbsp;Adriane Iurck Zonato,&nbsp;Ordival Augusto Rosa","doi":"10.1016/j.bjorl.2025.101656","DOIUrl":"10.1016/j.bjorl.2025.101656","url":null,"abstract":"<div><h3>Objective</h3><div>One lower-cost alternative to either manual or APAP titration is predicting therapeutic pressure by using mathematical formulas. This study aimed to determine whether the Miljeteig and Hoffstein predictor formula was equivalent to the pressure established by manual titration in a sleep laboratory in patients using nasal or pillow masks.</div></div><div><h3>Methods</h3><div>The authors analyzed all CPAP titration polysomnography studies in adult patients for three consecutive months (May 20th to August 19th, 2018) in a sleep-disorders clinic. CPAP pressures were manually titrated over the night. Anthropometric data (age, sex, Body Mass Index [BMI], Neck [NC] and waist circumference) and polysomnographic data were documented. We tested Miljeteig and Hoffstein model formula-predicted CPAP (<em>Hpred</em>) accuracy in our patients, comparing formula results to our manual titration; <em>Hpred</em> = (0.16 <em>BMI</em>) + (0.13 <em>NC</em>) + (0.04 <em>AHI</em>) - 5.12.</div></div><div><h3>Results</h3><div>Nasal masks were used in 55% of our patients (n = 86) and pillow masks in 45% (n = 71). There was no difference between groups for age, body mass index, neck circumference, waist circumference, gender, baseline apnea-hypopnea index, CPAP pressure and residual AHI during titration polysomnography. The mean difference obtained between CPAP pressure and <em>Hpred</em> formula was 2.4 cm H₂O. The CPAP pressure means during titration was 2.4 cm H₂O higher than pressure obtained by a formula for pillow group and 2.3 for the nasal group.</div></div><div><h3>Conclusions</h3><div>In most patients, formula underestimated the CPAP pressure obtained during titration for both nasal and pillow masks. Even though the pressure is underestimated, this approach could help to define minimum and maximum titration pressure using APAP in patients with OSA until the optimal pressure can be determined in the sleep laboratory if necessary.</div></div><div><h3>Level of evidence</h3><div>Level 3.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 5","pages":"Article 101656"},"PeriodicalIF":1.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169322","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":"Time heals. A study of thyroidectomy scars","authors":"Vergilius José Furtado de Araujo Filho,&nbsp;Vergilius José Furtado de Araujo-Neto,&nbsp;Leandro Luongo de Matos","doi":"10.1016/j.bjorl.2025.101641","DOIUrl":"10.1016/j.bjorl.2025.101641","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the quality of the thyroidectomy scars over a long period of time.</div></div><div><h3>Methods</h3><div>Over a period of two years the quality of the thyroidectomy scars among 283 consecutive patients was registered during their follow-up for malignancies. On a scale of 0 (excellent) to 3 (bad) thyroidectomy scars were classified according to the time after surgery.</div></div><div><h3>Results</h3><div>After 5 years or more 95% of the scars were classified as excellent or very good; 55% of them were excellent, which indicates that the scar was virtually invisible at a distance of 1.5 meters. Only 5% of the cases had a regular or bad scar after 5-years or more, and only one patient (0.5%) had a bad scar.</div></div><div><h3>Conclusion</h3><div>The scars remaining after thyroid surgery had an improved appearance with time, and the vast majority of patients had an excellent or very good scar after a period of five years or more.</div></div><div><h3>Level of evidence</h3><div>Level III.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 ","pages":"Article 101641"},"PeriodicalIF":1.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169768","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 the diameter of the thoracic inlet influence the formation of retrosternal goiter?","authors":"Leonardo Daniel Manzano Pasquel ,&nbsp;Daniel Abreu Rocha ,&nbsp;Yasmin Laryssa Moura Guimaraes ,&nbsp;Gustavo Fernandes de Alvarenga ,&nbsp;Mauricio Kase ,&nbsp;Júlia Scomparin Magalhãnes ,&nbsp;Regina Lúcia Elia Gomes ,&nbsp;Ledo Mazzei Massoni Neto ,&nbsp;Renata Lorencetti Mahmoud ,&nbsp;Leandro Luongo de Matos ,&nbsp;Vergilius José Furtado de Araujo Filho ,&nbsp;Claudio Roberto Cernea","doi":"10.1016/j.bjorl.2025.101597","DOIUrl":"10.1016/j.bjorl.2025.101597","url":null,"abstract":"<div><h3>Objective</h3><div>Find an association between diameter of the Thoracic Inlet (TI) and RSG to determine whether the TI would function as a natural anatomical barrier to prevent the passage of the goiters to the thoracic cavity.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted with patients submitted to total thyroidectomy, with goiter greater than 50 cm³, who underwent Computed Tomography (CT) preoperatively to measure the TI volume. The values obtained from each continuous variable of parametric distribution were organized and described as mean and standard deviation. The distributions were defined as non-parametric by the Kolmogorov-Smirnov test. The Mann-Whitney test was used to compare two sample populations.</div></div><div><h3>Results</h3><div>A total of 173 patients submitted to total thyroidectomy were evaluated, and 54 patients met the inclusion criteria of the study. 85.2% were female, with a mean age of 57-years. The mean diameter of the TI was 5679 mm². 42% of the patients presented some degree of RSG. The distance below the TI ranged from 0.2 to 5 cm.</div></div><div><h3>Conclusion</h3><div>No significant association was found between diameter of the thoracic inlet and retrosternal goiter, demonstrating that RSG can be present regardless of the TI diameter. Statistically significant association was observed between patients with larger thyroid volume and the likelihood of this tissue to extend to the thoracic cavity.</div></div><div><h3>Level of evidence</h3><div>Level IV.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 ","pages":"Article 101597"},"PeriodicalIF":1.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169766","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":"Epithelial-myoepithelial carcinoma: Retrospective analysis of the case series from a reference center in São Paulo, Brazil","authors":"Gabriela Miglioranza Gonçalves Luccas ,&nbsp;Kim Soares Marinho ,&nbsp;Lara Caroline Cardoso ,&nbsp;Maria Paula Spegiorin de Oliveira ,&nbsp;Renato Nobutaka Gotoda ,&nbsp;Dorival de Carlucci Junior ,&nbsp;Luiz Paulo Kowalski","doi":"10.1016/j.bjorl.2025.101615","DOIUrl":"10.1016/j.bjorl.2025.101615","url":null,"abstract":"<div><h3>Objective</h3><div>Given the recent increase in diagnoses in our service, a referral center in São Paulo, this study aims to analyze the case series at this center and compare it with the existing literature. The objective is to comprehend the characteristics and prognosis of this disease and provide insights to enhance its treatment.</div></div><div><h3>Methods</h3><div>Confirmed cases of EMC were selected at the Hospital das Clínicas da FMUSP between 2011 and 2021. Fourteen cases were screened and subjected to retrospective analysis of medical records for data collection.</div></div><div><h3>Results</h3><div>The analysis covered patient and disease characteristics. Of the total, 64.3% were female, with an average age of 71.33 years. The parotid gland was the predominant primary site (92.8%). Concerning staging, there was a significant prevalence in stages III and IVa. Among the cases, 12 underwent surgery, and eight patients received adjuvant therapy.</div></div><div><h3>Conclusion</h3><div>Despite EMC being a low-grade neoplasm, our case series, while aligning with much of the existing literature, revealed a more advanced presentation. This raises questions about whether this aggressiveness is due to late diagnosis or whether the neoplasm is less indolent than presumed.</div></div><div><h3>Level of evidence</h3><div>Level IV.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 ","pages":"Article 101615"},"PeriodicalIF":1.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169767","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":"Bedside conventional tracheostomy","authors":"Giancarlo Artese Araujo,&nbsp;Antonio Augusto Tupinambá Bertelli,&nbsp;Helvécio de Resende Urbano Neto,&nbsp;Marianne Yumi Nakai ,&nbsp;Caroline Schmiele Namur,&nbsp;Marcelo Benedito Menezes,&nbsp;Antonio José Gonçalves","doi":"10.1016/j.bjorl.2025.101602","DOIUrl":"10.1016/j.bjorl.2025.101602","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the open experience of Head and Neck Surgery division of Santa Casa in São Paulo with bedside tracheostomy.</div></div><div><h3>Methods</h3><div>A retrospective study of database tracheostomies was performed between 2013 and 2016. Then, age, gender, and main complications were analyzed.</div></div><div><h3>Results</h3><div>Analysis of 598 patients shows 9 cases (1.50%) of complications, bleeding was the cause in 6 cases (1.0%), 1 postoperative death (0.16%), 1 accidental decannulation case (0.16%) and 1 lesion in the posterior wall of the trachea (0.16%). It is possible to accomplish bedside open tracheostomy with safety.</div></div><div><h3>Level of evidence</h3><div>Level IV.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 ","pages":"Article 101602"},"PeriodicalIF":1.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169769","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":"Ansa cervicalis or ansa hypoglossi? A systematic review","authors":"Gustavo Henrique Pereira Boog ,&nbsp;Flávio Carneiro Hojaij ,&nbsp;Matheus Mychael Mazzaro Conchy ,&nbsp;Renan da Silva Bentes ,&nbsp;Flávia Emi Akamatsu ,&nbsp;Alfredo Luiz Jácomo","doi":"10.1016/j.bjorl.2025.101604","DOIUrl":"10.1016/j.bjorl.2025.101604","url":null,"abstract":"<div><h3>Objective</h3><div>To conduct a literature review on the relationship between the ansa cervicalis (or ansa hypoglossi) and the hypoglossal nerve, discussing this disparity in terminology, and determine which of these terms is the most suitable to identify this important nerve structure.</div></div><div><h3>Methods</h3><div>This is a systematic review of the literature based on studies found through a standardized search performed at the LILACS and MEDLINE/PUBMED databases; classic anatomy textbooks were also consulted.</div></div><div><h3>Results</h3><div>Forty-five of the 3731 articles found in the scientific research databases were selected and six classic anatomy textbooks were included in the study. Controversies involving the ansa cervicalis were analyzed and the results clearly showed that most textbooks describe its relationship with the hypoglossal nerve as a temporal junction, with no exchange of nerve fibers. The ansa cervicalis contains fibers arising from the cervical cord, and not from the hypoglossal nerve.</div></div><div><h3>Conclusion</h3><div>The term ansa cervicalis should be chosen to name this loop of nerves. The term ansa hypoglossi is not structurally correct, and should be abandoned in medical practice, the teaching of anatomy, and in scientific publications.</div></div><div><h3>Level of evidence</h3><div>Level II.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 ","pages":"Article 101604"},"PeriodicalIF":1.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169771","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":"Metastatic basal cell carcinoma: Case series and literature review","authors":"Mariana Gonçalves Rodrigues ,&nbsp;Aline Vieira de Lucena ,&nbsp;Gabriela Alves Domingues ,&nbsp;Caroline Marques de Aquino ,&nbsp;Deborah Yukiko Otto ,&nbsp;André Bandiera de Oliveira Santos ,&nbsp;Luiz Paulo Kowalski","doi":"10.1016/j.bjorl.2025.101619","DOIUrl":"10.1016/j.bjorl.2025.101619","url":null,"abstract":"<div><h3>Objective</h3><div>To present a metastatic head and neck basal cell carcinoma (BCC) series treated by a university teaching service between 1993 and 2021.</div></div><div><h3>Methods</h3><div>A review of medical records of 500 patients with high-risk BCC in the head and neck was performed. Tumors with a diameter greater than or equal to 6 mm in the “H” area of the face or greater than 10 mm in other head and neck areas; recurrences; sclerodermiform, micronodular and metatypical subtypes; and perineural invasion were considered factors indicating high-risk.</div></div><div><h3>Results</h3><div>Seven cases of metastatic head and neck BCC were diagnosed. The mean age at diagnosis of the primary tumor was 49.8 years, and the median time between the diagnosis of the primary tumor and that of metastases was 3 years (ranging from 1 to 20 years). The main site of metastasis was the lymph nodes. The main modalities of metastases treatment were surgery and radiotherapy.</div></div><div><h3>Conclusion</h3><div>BCC metastasis is a rare manifestation of a frequent disease. Post-treatment follow-up should include routine clinical examination of the neck for all patients and imaging for the diagnosis of metastases in symptomatic patients.</div></div><div><h3>Level of evidence</h3><div>Level IV.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 ","pages":"Article 101619"},"PeriodicalIF":1.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154751","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":"Accuracy of ultrasound performed by medical residents in operating rooms in identifying parathyroid glands in patients with hyperparathyroidism","authors":"Regison Rafael Dias Silva ,&nbsp;Giovanni Simões de Medeiros ,&nbsp;Murilo Catafesta das Neves","doi":"10.1016/j.bjorl.2025.101607","DOIUrl":"10.1016/j.bjorl.2025.101607","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the findings of US examinations performed by Head and Neck Surgery (HNS) resident physicians in patients in the preoperative period immediately before parathyroidectomy, and to compare these results with those of examinations performed preoperatively (ultrasonography and/ or scintigraphy) and with the findings of surgical procedures.</div></div><div><h3>Methods</h3><div>Patients in the preoperative period of parathyroidectomy underwent US examinations performed by HNS resident physicians after induction of anesthesia. The findings were registered and later compared with those of preoperative and intraoperative examinations using descriptive statistical analysis and calculation of sensitivity, specificity, and accuracy.</div></div><div><h3>Results</h3><div>At least one gland was identified in 81% of the patients, most commonly the left inferior parathyroid. There was 63% agreement between the examinations performed in the operating room and the preoperative examinations. Sensitivity of 76%, specificity of 100%, and accuracy of 81.25% were evidenced in identifying parathyroids &gt; 5 mm in patients with hyperparathyroidism associated with Chronic Kidney Disease (CKD), and sensitivity of 33% was found in patients with primary hyperparathyroidism.</div></div><div><h3>Conclusion</h3><div>US examinations performed by HNS resident physicians in patients preoperatively to parathyroidectomy are accurate (81.25%) in identifying parathyroids compared with intraoperative findings in patients with hyperparathyroidism associated with CKD.</div></div><div><h3>Level of evidence</h3><div>Level III.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 ","pages":"Article 101607"},"PeriodicalIF":1.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154760","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":"Thyroid cancer surgical indication during pregnancy: Systematic literature review and series of illustrative cases","authors":"Lucas Albuquerque Chinelatto,&nbsp;Flávio Carneiro Hojaij ,&nbsp;Dorival de Carlucci Jr.,&nbsp;Claudio Roberto Cernea","doi":"10.1016/j.bjorl.2025.101643","DOIUrl":"10.1016/j.bjorl.2025.101643","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate and discuss timing possibilities for surgical treatment in thyroid cancer in pregnant women.</div></div><div><h3>Methods</h3><div>Systematic literature review based on online search at the Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and National Center for Biotechnology Information (NCBI) databases. Retrospective analysis of thyroidectomies performed in the second trimester of pregnancy by the authors between 1999 and 2019.</div></div><div><h3>Results</h3><div>The systematic review included nine articles. Their conclusions diverge with respect to the optimal timing of thyroid surgery. The medical literature considers thyroidectomy after safe delivery. The most recent studies are more flexible regarding carrying out this surgery during the second trimester of pregnancy. In the authors’ experience (n = 5), surgical treatment during the second trimester of pregnancy is a good option for more aggressive tumors.</div></div><div><h3>Conclusion</h3><div>More aggressive cases of thyroid papillary carcinoma can be treated with surgery during the second trimester of pregnancy. Performing the surgery after delivery is safer in the case of less aggressive cancer cases. The decision should consider hospital costs, surgery risks, and patient anxiety in relation to cancer.</div></div><div><h3>Level of evidence</h3><div>Level II.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":"91 ","pages":"Article 101643"},"PeriodicalIF":1.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154752","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}