Perfusion-Uk最新文献

{"title":"Comparison of 13Fr versus 15Fr arterial return cannula for V-A ECMO in ECPR.","authors":"Nizar Osmani, Sundeep Guliani, Trenton Wray, Isaac Tawil, Todd Dettmer, Keith Azevedo, Jessica Mitchell, Miranda Morrison, Jonathan Marinaro","doi":"10.1177/02676591261420656","DOIUrl":"10.1177/02676591261420656","url":null,"abstract":"<p><p><b>Background:</b> Lower extremity ischemic complications of peripheral veno-arterial (VA) ECMO are common and variably reported across studies due to differences in definitions and distal perfusion practices, and are influenced in part by arterial cannula size.1,2 Typical arterial return cannula sizes used for adult ECPR are 17Fr or 15Fr.3. <b>Purpose:</b> We hypothesized that reducing arterial cannula size from 15Fr to 13Fr may reduce the need for distal perfusion catheter (DPC) placement for suspected cannula-associated threatened limb ischemia while maintaining adequate flows to support patients requiring ECPR. <b>Research Design and Study Sample:</b> We conducted a retrospective cohort analysis evaluating 39 adult ECPR patients at our center, comparing outcomes between those receiving 13Fr (<i>n</i> = 18) versus 15Fr (<i>n</i> = 21) arterial cannulas (Medtronic Bio-Medicus). <b>Analysis:</b> The primary endpoint was the rate of DPC placement for suspected cannula-associated limb ischemia. Secondary endpoints included ECMO flow parameters, illness severity markers, support duration, and 30-days survival. <b>Results:</b> The rate of DPC placement was significantly lower in the 13Fr group (16.7%) compared to the 15Fr group (47.6%, <i>p</i> = 0.04). There were no significant differences observed in survival rates, illness severity markers, or support duration between cohorts. <b>Conclusions:</b> These findings support the feasibility of smaller arterial cannulas as a strategy to reduce the need for additional limb reperfusion procedures in select ECPR patients.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1281-1288"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291796","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":"Cumulative elevation of aPTT predicts time to major bleeding and death in ECMO: A joint longitudinal-survival model.","authors":"Mohsyn Imran Malik, Nader S Aboelnazar, Mathieu Rheault-Henry, Thin Xuan Vo, A Dave Nagpal","doi":"10.1177/02676591251412301","DOIUrl":"10.1177/02676591251412301","url":null,"abstract":"<p><p>IntroductionAnticoagulation management during extracorporeal membrane oxygenation (ECMO) remains an important challenge, with bleeding rates reaching 30%. Activated partial thromboplastin time (aPTT) is the most used biomarker for heparin titration, however static values may not reflect real-time bleeding risk. We hypothesized that cumulative aPTT exposure offers superior predictive value for bleeding and mortality compared to traditional threshold-based approaches.MethodsIn this retrospective cohort study, we analyzed 109 adult ECMO patients at a single Canadian center (2006-2021). Serial aPTT values were recorded approximately every 6 h. The primary outcome was time to first major bleeding event (BARC ≥3), with death treated as a competing risk. We applied a joint longitudinal-survival modeling framework to evaluate associations between dynamic aPTT trajectories, including slope, variability, and cumulative exposure,and adverse outcomes. Models were adjusted for baseline covariates and compared using deviance information criterion (DIC) and time-dependent AUC.ResultsFifty-one patients (46.8%) experienced major bleeding. The best-performing model incorporated the cumulative exposure to elevated log-transformed aPTT, which significantly predicted both bleeding (HR 2.39, 95% CI: 1.17-4.88, <i>p</i> = 0.0084) and death (HR 7.88, 95% CI: 2.59-23.94, <i>p</i> < 0.0001). This model outperformed static or trend-based approaches (AUC 0.77 at 48 h). There results were robust to sensitivity analysis. Hematocrit and ECMO configuration were also significant covariates.ConclusionCumulative aPTT burden is a strong and independent predictor of bleeding and mortality in ECMO patients. These findings support a shift toward trajectory-based anticoagulation monitoring to enable safer, personalized management in this high-risk population.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1207-1214"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893009","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":"Predicting bloodless aortic aneurysm repair: A simple point system.","authors":"Gift Owolabi, Kavya Rajesh, Yanling Zhao, Paul Kurlansky, Bessie Kachulis, Adham Elmously, Thomas Fx O'Donnell, Virendra I Patel, Hiroo Takayama","doi":"10.1177/02676591251408641","DOIUrl":"10.1177/02676591251408641","url":null,"abstract":"<p><p><i>Introduction</i> Patients who decline blood transfusion for religious or personal reasons present a unique challenge in cardiac surgery. We developed and validated a preoperative point-based tool to predict the likelihood of achieving transfusion-free success in open proximal thoracic aortic aneurysm repair.<i>Methods</i> We retrospectively analyzed 1074 patients who underwent open proximal thoracic aortic aneurysm repair at a single academic center from 2012 to 2023. A multivariable logistic regression model was developed using cross-validation to identify independent predictors of bloodless success. Model performance was evaluated using area under the curve (AUC), Brier score, and F-score. A point system was derived from weighted coefficients of significant preoperative variables.<i>Results</i> Multivariable analysis identified 8 factors (<i>p</i> < 0.05) associated with bloodless aneurysm repair for the point system: body surface area (BSA), hypertension, reoperation, heart failure, baseline hemoglobin, extent of repair, concomitant procedure, and degree of hypothermia. The model demonstrated good discrimination (AUC = 0.761), calibration (Brier score = 0.192), and balance (F-score = 0.758). BSA ≥1.9 m² and preoperative hemoglobin ≥13.1 g/dL (+8 points each) had the greatest positive influence on likelihood of bloodless operation, while proximal + distal extension in repair (-8 points) had the greatest negative influence on likelihood of bloodless operation.<i>Conclusions</i> This novel point-based scoring tool estimates the probability of transfusion-free success using readily available preoperative factors. It may assist in counseling patients who refuse blood products, guiding perioperative planning, and prioritizing resource-intensive optimization strategies for those at highest risk.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1167-1176"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811754","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":"Ascending aorta pseudoaneurysm 40 years following surgical atrial septal defect repair - A case report and literature review.","authors":"Hong Jun Yong, Peter Lang, Ramanish Ravishankar, John Dreisbach, Gruschen Veldtman, Robyn Smith, Sukumaran Nair","doi":"10.1177/02676591251408657","DOIUrl":"10.1177/02676591251408657","url":null,"abstract":"<p><p>IntroductionAscending aortic pseudoaneurysm is a rare postoperative complication of cardiac surgery, often linked to infection and dehiscence at sites of aortotomy, cannulation, cross-clamp sites, and proximal coronary anastomoses.Case ReportWe present a case of an ascending aortic pseudoaneurysm in 48-year-old woman who underwent atrial septal defect repair at 8 years old. Based on pre-operative imaging and intra-operative findings, the pseudoaneurysm developed from previous cardioplegia cannula site. She underwent emergency surgery where the pseudoaneurysm was resected and repaired with a Gelweave patch. The patient recovered well with no post-operative chest pain or dyspnoea at 5-months follow-up.ConclusionCardioplegia cannula remains a rare but significant iatrogenic cause of aortic pseudoaneurysm. Prevention of pseudoaneurysm formation can be achieved by inserting the cardioplegia cannula tip through full-thickness purse-strings and/or addition of separate oversewing sutures after decannulation during the primary operation.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1327-1329"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794935","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":"Bridge to recovery: A case of V-V ECMO following V-A ECMO in Eisenmenger syndrome.","authors":"Alessandra M Riccio, Nathnael Feleke, Nicole Palmer, Linjia Jia, Natalia I Girardi, Charles A Mack, Ningxin Wan, Iosif M Gulkarov, Berhane M Worku, Ankur Srivastava","doi":"10.1177/02676591251406127","DOIUrl":"10.1177/02676591251406127","url":null,"abstract":"<p><p>We report a case of successful treatment for a severe acute pulmonary hypertension crisis in a patient with Eisenmenger syndrome (ES) associated with patent ductus arteriosus following trauma-related spine surgery, utilizing both veno-arterial (V-A) and veno-venous (V-V) ECMO. The patient's clinical course was complicated by right ventricular failure amid a pulmonary hypertensive crisis, necessitating V-A ECMO support. Persistent hypoxia, despite improved right heart function, warranted transition to V-V ECMO. This case demonstrates that peripheral V-A ECMO can be safely employed to decompress the right heart in the presence of a significant PDA shunt. Furthermore, weaning from ECMO in these patients requires a much higher hematocrit in order to compensate for the chronic hypoxia.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1323-1326"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642153","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":"From Technology to Teamwork: The Evolving Landscape of Extracorporeal Support.","authors":"Dirk W Donker","doi":"10.1177/02676591261479910","DOIUrl":"10.1177/02676591261479910","url":null,"abstract":"","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1083-1086"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800784","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":"Neonatal ECMO outcomes in transported versus in-house patients: A single-center study.","authors":"Eitan Keizman, Evyatar Hubara, Tal Sadeh, Yelena Skourikhin, Marina Rubinshtein, Guy Dumanis, Itai M Pessach, David Mishaly, Uri Pollak, Reut Kassif Lerner","doi":"10.1177/02676591251409381","DOIUrl":"10.1177/02676591251409381","url":null,"abstract":"<p><p>BackgroundExtracorporeal membrane oxygenation (ECMO) is a life-saving intervention for neonates with severe respiratory or circulatory failure. Due to its complexity, ECMO is often performed in specialized centers, necessitating the transport of eligible patients from non-ECMO centers. While ECMO transport has been deemed safe, limited data exist comparing outcomes between in-house and transported neonates. This study aimed to evaluate the survival and long-term outcomes of neonates requiring ECMO support based on the cannulation location.MethodsA single-center study was conducted at the largest tertiary center in Israel (2009-2025). Patients were categorized based on cannulation site: in-house ECMO (performed at the tertiary center) or on-site ECMO (cannulated at the referring center and transported on ECMO support). Primary endpoints were in-hospital and long-term survival. Secondary outcomes included ECMO-related complications and long-term sequelae.ResultsA total of 53 neonates received ECMO support, with 26 (49.1%) in the in-house group and 27 (50.9%) in the on-site group. Despite pre-cannulation differences, including higher vasoactive-inotropic scores in the in-house group, lower pH and higher pCO2 in the on-site group, there were no statistically significant differences between the groups (53.8% vs 77.8%, p = 0.12). ECMO-related adverse events and long-term sequelae showed no statistically significant differences between groups, though the study was underpowered to detect clinically meaningful differences.ConclusionAlthough survival rates of critically ill neonates requiring on-site ECMO initiation and transport and those connected to ECMO in the in-house setting, did not differ significantly, the study was underpowered to detect potentially meaningful differences. Nonetheless, the findings reinforce the viability of neonatal ECMO transport.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1190-1197"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806310","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":"How does rewarming temperature affect bleeding after mitral valve repair?","authors":"Yu-Hua Cheng, Yun-Fei Han, Jian-Wen Zeng, Wei-Guo Ma, Kai Sun, Shao-Qing Lei, Wei-Qin Huang","doi":"10.1177/02676591261422997","DOIUrl":"10.1177/02676591261422997","url":null,"abstract":"<p><p>ObjectiveSo far, evidence is scarce regarding the impact of rewarming temperature on bleeding after cardiac surgery under cardiopulmonary bypass (CPB). We seek to evaluate how rewarming temperature affects postoperative bleeding in patients undergoing mitral valve repair.MethodsClinical, anesthesia and CPB data were analyzed for 379 adults undergoing isolated mitral regurgitation repair. Platelet levels (1000/μL) were divided into three groups: low, 53-164 (<i>n</i> = 128); medium, 165-208 (<i>n</i> = 126); and high, 209-906 (<i>n</i> = 125). The primary endpoint was chest drainage volume (mL) at 24 postoperative hours. To delineate the degree and impact of rewarming, a variable \"rewarming/cooling ratio\" was defined as: peak rewarming temperature (°C) divided by nadir cooling temperature (°C). General linear models were used to evaluate factors associated with the volume of 24-h chest drainage.ResultsMean flow rate was 2.7 ± 0.1 L/min/m², nadir core temperature 30.7 ± 1.3°C and peak rewarming temperature 36.2 ± 0.5°C. The \"rewarming/cooling ratio\" averaged 1.133 ± 0.044.Postoperatively, nadir platelet count was 115 ± 46 k/μL, and chest drainage averaged 344 ± 181 mL at 24 h. Two patients underwent re-exploration for bleeding (0.5%). Transfusion was required in 85 patients (22.4%).Gender (F = 20.585, <i>p</i> < 0.001), platelet count (F = 3.875, <i>p</i> = 0.024), fibrinogen (F = 4.241, <i>p</i> = 0.040), and chest incision (F = 58.097, <i>p</i> < 0.001), rather than the rewarming temperature (F = 2.322, <i>p</i> = 0.128), were factors significantly associated with 24-h chest drainage.A significant interaction existed between platelet levels and \"rewarming/cooling ratio\" (F = 3.717, <i>p</i> = 0.025), i.e., with a higher \"rewarming/cooling ratio\", 24-h chest drainage tended to increase in the low platelet group, and to decrease in patients with high and medium platelet levels.ConclusionsIn this series of patients undergoing isolated mitral regurgitation repair, gender, platelet count, fibrin and chest incision, rather than rewarming temperature, were independent factors significantly associated with postoperative bleeding. The impact of rewarming temperature on postoperative bleeding was modified by preoperative platelet levels. It is advisable to avoid excessive cooling during CPB and keep the cooling temperature at maximally allowable level.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1289-1297"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158399","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":"Laboratory factors and diagnostic aids for compartment syndrome in extracorporeal membrane oxygenation: An exploratory single-center study.","authors":"Manuj M Shah, Mitchell S Jay, Xiyu Zhao, Victor B Yang, Siam T Muquit, Chetan Pasrija, Antonio Polanco, Glenn Whitman, Bo Soo Kim, Sung-Min Cho, Babar Shafiq, Henry T Shu","doi":"10.1177/02676591261420646","DOIUrl":"10.1177/02676591261420646","url":null,"abstract":"<p><p>PurposeExtracorporeal membrane oxygenation (ECMO) patients have increased risk for limb acute compartment syndrome (ACS), but diagnosis remains difficult given the lack of subjective and pulsatility assessments in this patient population. This exploratory study characterized ECMO patients who developed ACS and investigated laboratory measures that can aid diagnosis.MethodsWe reviewed records of adult patients placed on ECMO between 2016 and 2022 at our single center, collecting clinical, laboratory, and survival data upon cannulation. We performed comparisons of baseline and laboratory data between ACS and No ACS patients. Threshold regression was then used to develop laboratory cutoffs for ACS diagnosis and logistic regression to characterize predictors of ACS. Survival analysis relied on Cox proportional hazards modeling.Results278 ECMO patients were included, of which 14 (5%) developed ACS. ACS patients had a higher amputation rate (21.4% vs 1.9%, <i>p</i> < 0.001) and mortality risk (HR 2.35, <i>p</i> = 0.03); only 1 (7%) ACS patient had amputation-free survival. The most sensitive threshold cutoffs included maximum INR >1.95 (sensitivity 0.91), baseline lactate >7.85 (0.88), and 24-h lactate >3.75 (0.88). The most specific were baseline CpK >3765.5 (specificity 0.91), maximum K >5.95 (0.88), and maximum CpK >6362.0 (0.85). Laboratory values, namely CpK and lactate, predicted ACS with promising diagnostic sensitivity and specificity.ConclusionsACS remains associated with increased mortality and morbidity, most often occurring within 24 h after cannulation. Laboratory values, namely CpK and lactate values, independently predicted ACS development with promising sensitivity and specificity. These exploratory findings may help guide decision-making surrounding ACS in the ECMO setting.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1271-1280"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031519","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":"Vacuum-assisted venous drainage versus gravitational venous drainage in patients undergoing cardiac surgery: A meta-analysis.","authors":"Karam R Motawea, Ahmed Farid Gadelmawla, Momen Mohamed Ibrahim, Tarek Soliman, Yasameen A Kheuka, Adam Tzagournis, Mohammad El Diasty, Yasir Abu-Omar, Marc Pelletier","doi":"10.1177/02676591251409379","DOIUrl":"10.1177/02676591251409379","url":null,"abstract":"<p><p>IntroductionVacuum-assisted venous drainage (VAVD) has been proposed as a better alternative option than conventional gravitational venous drainage (GVD) in cardiac surgery. However, the literature reports conflicting results between both methods in terms of post-cardiac surgery complications. Therefore, we aimed to perform a meta-analysis to compare clinical outcomes between VAVD and GVD in patients undergoing cardiac surgery.MethodsPubMed, Scopus, and Web of Science databases were searched for any randomized control trials or cohort studies that compared clinical outcomes between VAVD and GVD in patients undergoing cardiac surgery.ResultsSixteen studies with 8426 patients were included in our study. The pooled effect estimate of the postoperative results showed a statistically significant association between VAVD and decreased blood loss/chest tube drainage (MD = -88.7, 95% CI = -154.71 to -22.69, <i>p</i>-value = 0.008), amount of packed red blood cells (pRBC) transfusion (MD = -0.25, 95% CI = -0.27 to -0.22, <i>p</i> < 0.00,001), re-exploration (RR = 0.6, 95% CI = 0.35 to 1, <i>p</i> = 0.05), and re-operation (RR = 0.47, 95% CI = 0.23 to 0.99, <i>p</i>-value = 0.05). However, our study revealed no significant difference between both groups in terms of postoperative mortality, hospital/ICU stay, other blood product transfusions, change of free hemoglobin at 24 h, and other clinical outcomes.ConclusionOur study revealed that VAVD is at least equivalent and may provide some benefits compared to GVD in patients undergoing cardiac surgery. While, VAVD requires specific expertise and training in order to optimize its outcomes, its ability to reduce blood loss and blood transfusion, support its use as a valuable alternative for GVD in high-risk groups.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1177-1189"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794937","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}