Journal of Infection in Developing Countries最新文献

{"title":"Retrospective study: China's pediatric hospital infections before and during the COVID-19 pandemic.","authors":"Xue Wang, Min Shi","doi":"10.3855/jidc.20672","DOIUrl":"https://doi.org/10.3855/jidc.20672","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic probably influenced the incidence of healthcare-associated infections (HAIs) in pediatric hospitals. This study aimed to assess HAIs and the impact of multidrug-resistant organisms in pediatric intensive care units (ICUs) before and during the pandemic.</p><p><strong>Methodology: </strong>This retrospective study was conducted at the Children's Hospital of Soochow University from January 2017 to December 2022, covering various ICU units. Statistical analyses compared HAI rates, including Ventilator-associated pneumonia (VAP), central line-associated bloodstream infections (CLABSI), and catheter-associated urinary tract infections (CAUTI), and the prevalence of multidrug-resistant pathogens.</p><p><strong>Results: </strong>Child hospital admissions were analyzed, with 185,116 admissions pre-pandemic and 218,681 during the pandemic. The average length of stay (LOS) increased across ICU units. Overall, the HAI rates declined from 2.7 to 1.79 (p < 0.01) with NICU rates decreasing from 2.93 to 2.07 (p < 0.01) and SICU rates from 7.17 to 4.56 (p < 0.01) except for general ICUs. VAP rates declined in the general ICU and NICU, while the rates in the SICU remained statistically unchanged. The CLABSI and CAUTI rates remained stable across all ICUs. The total count of multidrug-resistant bacteria increased by 41 instances with significant increases in gram-negative bacteria, particularly CRPA (13%) and CRAB (3%), while MRSA decreased by 12%. CRE strains decreased by 10 counts in the NICUs, while CRAB increased by 12 in the general ICUs and by 8 in the SICUs.</p><p><strong>Conclusions: </strong>This study reveals a significant HAI decline in pediatric hospitals during the pandemic, suggesting implications for pediatric ICU infection control.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"19 5","pages":"669-676"},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200600","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":"Decreased risk of nosocomial transmission of hepatitis B and C viruses among hemodialysis patients in Southern Bulgaria.","authors":"Radka T Komitova, Elitsa N Golkocheva-Markova, Ani K Kevorkyan, Lubomira Nikolaeva-Glomb, Vanya R Rangelova, Tanya I Kostadinova, Tsvetelina Chardakova, Mariya V Atanasova, Tencho D Tenev, George S Kiprin, Simon K Sariyan, Ralitsa D Raycheva, Valeri D Tzekov","doi":"10.3855/jidc.20035","DOIUrl":"https://doi.org/10.3855/jidc.20035","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatitis B (HBV) and (HCV) virus infections represent a nosocomial risk in hemodialysis (HD) patients. We aimed to evaluate the risk among adult HD patients in southern Bulgaria.</p><p><strong>Methodology: </strong>A prospective cohort study included 225 patients from three HD centers between January 2020 and June 2022. HBV and HCV infections were characterized by serological and virological markers determined through enzyme-linked immunosorbent assay and polymerase chain reaction.</p><p><strong>Results: </strong>HBV infection was detected in 13 patients and HCV in 15. Ten of the hepatitis patients died of non-liver-related complications. Sustained virological response (SVR) was confirmed in five HCV-infected patients previously cured with direct-acting antivirals (DAAs). Five patients were viremic. Three of them achieved SVR after DAAs, and two refused treatments. A decrease in HCV viremia prevalence (2.22% versus 0.89%) was recorded (p = 0.15). Virological suppression was confirmed in four HBV-infected patients treated with nucleos(t)ide analogs. Тwo patients were not eligible for antivirals. Decreased HBV viremia prevalence (2.7% versus 0.89%) was recorded (p = 0.15). Among HBV surface antigen (HBsAg)-negative patients, HBV vaccination coverage was 62.74% (133/212) and higher in 2 HD centers (128/137; 93.43%). Nevertheless, one-third of participants (34/112; 30.36%) were susceptible to HBV. Twenty-four vaccinees (24/112; 21.43%) had acquired natural immunity but remained at risk of reactivation in case of immunosuppression. HBV DNA was detected in eight HBsAg-negative patients, resulting in a prevalence of 7.14% (8/112) for occult HBV infection.</p><p><strong>Conclusions: </strong>The study reveals a downward trend in HBV and HCV viremia prevalence among HD patients. To further reduce the risk of nosocomial transmission, vaccination for hepatitis B requires updating.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"19 5","pages":"782-791"},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200617","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 Gram-negative hospital-acquired infections and antibiotic resistance in the pediatric intensive care unit.","authors":"Berfin Özgökçe Özmen, Merve Türkegün Şengül, Suna Ozdem, Sefika Aldaş, Banu Katlan","doi":"10.3855/jidc.20437","DOIUrl":"https://doi.org/10.3855/jidc.20437","url":null,"abstract":"<p><strong>Introduction: </strong>We retrospectively analyzed the frequency of healthcare-associated infections (HAIs), infection sites, Gram-negative microorganisms in the cultures, and antibiotic resistance patterns; recorded in the pediatric intensive care unit (PICU); between 2017 and 2023; based on the records in our hospital's infection control surveillance system. Our aim was to determine the state of infections over the years and the status of antibiotic resistance.</p><p><strong>Methodology: </strong>Medical records of PICU patients, between 1 January 2017 and 31 July 2023, whose cultures were identified to have Gram-negative bacterial growth, were evaluated retrospectively.</p><p><strong>Results: </strong>A total of 125 nosocomial infections were recorded. Pseudomonas aeruginosa and Klebsiella pneumoniae were the most frequently identified and had equal growth rates in blood culture. K. pneumoniae were most frequently identified in the central venous catheter (CVC). Mortality was significantly higher for patients with fungal growth, congenital diseases, and males (p < 0.05); except in patients with CVC. Patients with congenital diseases had a shorter median survival time (65 days) compared to chronic disease patients (151 days; p < 0.005). Cox regression analysis indicated that comorbidity was a significant risk factor for survival time. The risk of mortality was 3.074 times higher in patients with congenital disease compared with chronic disease patients (HR = 3.074; 95% CI: 1.577-5.995). Gender had a significant relationship with mortality; however, survival times did not differ between genders (p > 0.05).</p><p><strong>Conclusions: </strong>Gram-negative bacterial infections are becoming more prevalent in intensive care units, and effective control and prevention policies are needed for these infections.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"19 5","pages":"747-754"},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200633","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":"SARS-CoV-2 associated encephalitis.","authors":"Jasmina Poluga, Aleksandra Barać, Nataša Katanić, Branko Milošević, Nataša Nikolić, Goran Stevanović, Jovan Malinić, Uroš Karić, Boris Jegorović, Miloš Šabanović, Martina Jug, Jaroslava Jovanović, Ivana Poluga, Svetislav Pelemiš, Mirjana Stjepanović, Jelena Micić","doi":"10.3855/jidc.19952","DOIUrl":"https://doi.org/10.3855/jidc.19952","url":null,"abstract":"<p><strong>Introduction: </strong>In addition to known systemic manifestations, coronavirus disease (COVID-19) can cause serious neurological manifestations as a result of damage to the central and peripheral nervous system.</p><p><strong>Case report: </strong>A 62-year-old male with medical history of arterial hypertension and type 2 diabetes mellitus was admitted to the hospital, complaining of high fever, fatigue, cough, and disturbed mental state. He was diagnosed with COVID-19, had fever of up to 38 °C 7 days before admission, dry cough, and became disoriented and psychotic after 5 days. The chest X-ray and computed tomography (CT) of the head were normal. Following a lumbar puncture, the patient was diagnosed with encephalitis based on clinical and laboratory findings (pleocytosis and hyperproteinorachia in cerebrospinal fluid (CSF)). CSF was checked with the polymerase chain reaction meningitis-encephalitis panel which excludes the more common viral or bacterial causes of encephalitis. Anti-edematous, anti-inflammatory, anticoagulant, gastroprotective, and other symptomatic medications were administered. Ataxic gait was the only focal neurological abnormality identified during neurological assessment. The chest CT did not reveal COVID-19 pneumonia and brain magnetic resonance imaging revealed only cortical reductive brain alterations. The COVID-19 swab test after 10 days was negative. The patient was recovered and released from hospital treatment with normal physical findings and without neurological abnormalities.</p><p><strong>Conclusions: </strong>The diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) encephalitis can be challenging, and it is usually based on the exclusion of other etiological agents of brain infections.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"19 5","pages":"649-653"},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200602","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":"Development and validation of a clinical prediction model for Clostridioides difficile associated diarrhea.","authors":"Ruiying Zheng, Hewei Luan, Jun Zhou, Zhixin Shi, Xin Hong, Lei Huang, Genyan Liu","doi":"10.3855/jidc.20006","DOIUrl":"https://doi.org/10.3855/jidc.20006","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to develop and validate a clinical prediction model for Clostridioides difficile associated diarrhea (CDAD) based on routine laboratory tests.</p><p><strong>Methodology: </strong>Data from 121 CDAD patients and 123 patients with non-CDAD who presented at the First Affiliated Hospital of Nanjing Medical University between May 2017 and January 2022 were used to create a nomogram based on logistic regression. In addition, 109 stool samples from diarrhea patients in Jurong People's Hospital were collected to detect Clostridioides difficile toxin genes. The performance of the prediction model was assessed by the area under the curve (AUC), Hosmer-Lemeshow goodness of fit, and decision curve analysis (DCA).</p><p><strong>Results: </strong>The following variables were included in the new multivariate regression model: white blood cell (WBC), lymphocyte (LY), hemoglobin (HGB), mean corpuscular volume (MCV), activated partial thromboplastin time (APTT), D-dimer, urea, creatinine (Cr), and uric acid (UA). The AUC of the prediction model was 0.793 (95% CI = 0.737-0.849) for the derivation sets and 0.708 (95% CI = 0.506-0.910) for the validation set. The calibrated values were 0.874 and 0.543, respectively. The nomogram showed better net benefit when prediction probability values were above 0.1 in the DCA curve.</p><p><strong>Conclusions: </strong>A new diagnostic prediction model for CDAD was established. Clinicians can use the nomogram to initially assess the likelihood of CDAD when the patient suffers diarrhea, to ensure timely specific laboratory tests, and appropriate diagnostic and treatment measures.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"19 5","pages":"766-775"},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200618","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":"Assessing COVID IGRA and IgG antibodies in healthcare workers post vaccination.","authors":"Lina Ghandour, Wissam Yaacoub, George F Araj","doi":"10.3855/jidc.20732","DOIUrl":"https://doi.org/10.3855/jidc.20732","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the durability of humoral and cell-mediated immunity (CMI) post Pfizer vaccination among healthcare workers (HCWs) at a tertiary care center in Lebanon.</p><p><strong>Methodology: </strong>A total of 42 HCWs were enrolled, with their past infection and/or vaccination duration ranging between 2 months and 2 years. Blood samples were tested for COVID CMI and humoral immunity simultaneously. Testing for COVID CMI was done by measuring the interferon gamma-release assay (IGRA) using the QuantiFERON SARS-CoV-2 test, and for COVID humoral immunity using the lateral flow Cellex qSARS-CoV-2 IgG/IgM Rapid Test.</p><p><strong>Results: </strong>The study group was 69% female and 31% male, aged 22-51 years. SARS-CoV-2 was contracted by 33 (78%) HCWs. Positive COVID humoral IgG and CMI response were found among 35 (83.3%) and 19 (45.2%) HCWs, respectively. Combining the findings for both tests revealed concordant positivity in 35.7%, concordant negativity in 7.1%, Pos IgG - Neg IGRA in 47.6%, and Neg IgG - Pos IGRA in 9.5%.</p><p><strong>Conclusions: </strong>Generally, no correlation was established between humoral and CMI responses following COVID-19 vaccination. That only 83.3% and 45.2% among the Pfizer-vaccinated HCWs tested positive for COVID humoral and CMI, respectively, prevents substantial conclusions about test reliability for determining immunity status post vaccination. Whether these results are influenced by the specific antigenic epitopes used in the tests or by the potential deterioration of the immune response over time remains to be determined. The incongruity between humoral and CMI responses post-vaccination suggests the need for more comprehensive testing methodologies to assess post-vaccination immunity.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"19 5","pages":"654-660"},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200614","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":"A global bibliometric analysis of Salmonella Typhi over the past 52 years (1970-2022).","authors":"Serap Kılıç Altun, Mehmet Emin Aydemir, Sevil Alkan","doi":"10.3855/jidc.17946","DOIUrl":"https://doi.org/10.3855/jidc.17946","url":null,"abstract":"<p><strong>Introduction: </strong>Salmonella Typhi (S. Typhi), a bacterial human-restricted pathogen, is an essential systemic health problem of global importance in humans and animals. This study aimed to determine the overall scientific impact of Salmonella Typhi (S. Typhi) research using bibliometric methods.</p><p><strong>Methodology: </strong>In this research, a bibliometric analysis was performed on S. Typhi using the Web of Science (WoS) database and the Bibliometrix R package. A total of 1,966 articles, published between 1970-2022, were analysed.</p><p><strong>Results: </strong>This bibliometric analysis showed that the most productive years in the process were 2012 and 2022. This analysis also showed that Infection and Immunity Journal was the leading journal with a total of 1,332 articles in publications related to S. Typhi research, with the USA being the most productive country in S. Typhi publications, as well as having the highest co-authorship collaboration. The University System of Maryland ranked first with 110 records when affiliations were analysed. The United States Department of Health and Human Services was at the top of the Funding Agencies analysis. Analysis of the most cited authors revealed that Parry CM was the first most cited author (n = 90) of S. Typhi publications.</p><p><strong>Conclusions: </strong>This bibliometric analysis showed that the countries with high economic income were dominant in the studies of published articles, affiliations, and funding agencies on S. Typhi. Collaboration of researchers from countries with low or middle incomes with S. Typhi epidemics and researchers from countries with high economic income will make the fight against these bacteria more effective.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"19 5","pages":"691-698"},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200613","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":"Outcomes and mortality risk scoring for infections caused by carbapenem-resistant Escherichia coli and Klebsiella pneumoniae.","authors":"Jack El Sawda, Jawan Abdulrahim, Rayyan Wazzi Mkahal, George Doumat, Tamara Nawar, Antoine Saliba, Souha S Kanj, Zeina A Kanafani","doi":"10.3855/jidc.20725","DOIUrl":"https://doi.org/10.3855/jidc.20725","url":null,"abstract":"<p><strong>Introduction: </strong>Carbapenem-resistant Enterobacterales (CRE) are becoming increasingly prevalent and have been associated with increased mortality. Due to the paucity of data from the region, we evaluated the risk factors and outcomes of infections caused by CRE at a tertiary care center in Lebanon.</p><p><strong>Methodology: </strong>The study had three arms in a case-case-control design: patients with CRE infections, patients with infections due to ceftriaxone-resistant carbapenem-susceptible Enterobacterales (CSE), and uninfected controls (UC). Logistic regression was performed to identify risk factors uniquely associated with CRE. A CRE infection score was also created to assess the likelihood of having a CRE infection.</p><p><strong>Results: </strong>We included 337 patients (112 CRE, 75 CSE, 150 UC). Predictors unique to CRE infection included recent surgery (Odds Ratio (OR) 25.7; 95% confidence interval (CI95 5.7-115.2), carbapenem use within 30 days (OR 19.1; CI95 3.3-109.6), and malignancy (OR 4.2; CI95 1.6-10.5). The mean CRE score was 4.2 ± 2.2 in the CRE group and 2.4 ± 2.4 in the CSE group (p < 0.001). Infection-related mortality was higher among CRE patients (63.6% vs. 20.0%; p = 0.015), and CRE was independently associated with all-cause in-hospital mortality.</p><p><strong>Conclusions: </strong>We developed a scoring system that would allow risk stratification and would guide empiric antibiotic therapy. CRE infections were associated with a worse outcome compared to CSE infections.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"19 5","pages":"683-690"},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200640","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":"Global concerns on the recent resurgence of influenza A variant viral infection in humans.","authors":"Subrat Kumar, Ritesh Pattnaik, Basavaraj Mathapati, Rik Ghosh, Sugato Tripathy","doi":"10.3855/jidc.20750","DOIUrl":"https://doi.org/10.3855/jidc.20750","url":null,"abstract":"","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"19 5","pages":"797-799"},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200634","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":"Colopleurocutaneous fistula associated with empyema as a late complication of colorectal cancer.","authors":"Milan Savic, Zeljko Garabinovic, Nikola Colic, Marko Kostic, Miljan Ceranic, Jovan Peric, Mihailo Stjepanovic","doi":"10.3855/jidc.19318","DOIUrl":"https://doi.org/10.3855/jidc.19318","url":null,"abstract":"<p><strong>Introduction: </strong>Pleurocutaneous fistula is a pathological communication of subcutaneous tissue with the pleural cavity, and can occur as a result of infectious, malignant processes and iatrogenic procedures. Colopleural fistula is rare and is mainly caused by processes in the abdomen. The appearance of empyema is usually described as a complication of colopleural fistulas that are the result of pathological processes in the abdomen.</p><p><strong>Case presentation: </strong>We report an extremely rare case of colopleurocutaneous fistula with pleural empyema present, 8 years after left hemicolectomy due to colon adenocarcinoma. Radiological diagnostic procedures performed confirmed the existence of colopleurocutaneous fistula. The patient was given antibiogram therapy and regular thoracocentesis for empyema, as well as a fistulous canal toilet.</p><p><strong>Conclusions: </strong>After achieving sterility of the fistulous canal and regression of empyema, the fistulous canal was closed with fibrin glue, and during the next 6 months follow-up, there was no reopening of the fistula, nor did the patient have any other complications.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"19 5","pages":"800-803"},"PeriodicalIF":1.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200616","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}