Perfusion-Uk最新文献

{"title":"Staged mechanical circulatory support in paediatric HIT: Bivalirudin anticoagulation across ECMO, VAD, and cardiac transplantation.","authors":"Arun Beeman, Richard W Issitt, Mary Mathias, Marc Cohen, Craig Laurence, Nagarajan Muthialu, Martin Kostolny, Timothy Thiruchelvam","doi":"10.1177/02676591251413743","DOIUrl":"10.1177/02676591251413743","url":null,"abstract":"<p><p>IntroductionHeparin induced thrombocytopenia (HIT) with in paediatric population is rare and subsequent anticoagulation management is challenging. Bivalirudin is a viable alternative to heparin for anticoagulating paediatric patients with HIT, though clinical data are limited. We describe the successful management of anticoagulation with bivalirudin from diagnosis through Extracorporeal Membrane Oxygenation (ECMO), Ventricular Assist Device (VAD) implantation, and heart transplantation in a child with dilated cardiomyopathy and HIT.MethodsA 14-year-old girl presented with acute heart failure, intracardiac thrombi, and adenovirus positivity. Heparin was exchanged for bivalirudin once HIT criteria were met, associated with thrombocytopenia and progressive thrombus formation within the right atrium and superior vena cava (SVC). Due to end-organ dysfunction and refractory cardiac failure veno-arterial ECMO was initiated. Failure to achieve sufficient recovery prompted a VAD implantation, and subsequent orthotopic heart transplantation both managed using a modified bivalirudin protocol.ResultsManaging ECMO in the presence of HIT and intracardiac thrombi required careful multidisciplinary planning. We adjusted the bivalirudin infusion from 0.35 to 1.9 mg/kg/hr to maintain an activated Partial Thromboplastin Time (aPTT) of 60-90 s, following our institutional protocol. For VAD implantation, we used citrate for circuit priming and initiated cardiopulmonary bypass without heparin, administering six bivalirudin boluses and escalating the infusion from 1.62 to 10 mg/kg/hr to achieve an Activated Clotting Time (ACT) > 400 s, with continuous ACT monitoring. During transplantation, anticoagulation involved four boluses and increasing the infusion from 0.35 to 5 mg/kg/hr to maintain an ACT >400 s. Despite significant post-CPB coagulopathy, which required delayed chest closure to control bleeding, no thrombotic events occurred. The bivalirudin protocols allowed safe progression through all three phases.ConclusionBivalirudin strategy provided safe, effective antithrombotic management across ECMO, VAD implantation, and heart transplantation in a paediatric patient with HIT. Monitoring its effectiveness at higher anticoagulation levels remains challenging, and patients may require higher doses to achieve desired endpoints.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1231-1237"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846300","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":"Correlation of anticoagulation assays with bleeding during extracorporeal membrane oxygenation at a tertiary pediatric hospital.","authors":"Mohammed Salameh, Jazmin Delgado, Ryan Killebrew, Cody Henderson, Elumalai Appachi","doi":"10.1177/02676591261417542","DOIUrl":"10.1177/02676591261417542","url":null,"abstract":"<p><p>IntroductionDue to anticoagulation during Extracorporeal Membrane Oxygenation (ECMO), patients face a higher risk of bleeding. This study aimed to assess the correlation between anticoagulation assays and hemorrhage in ECMO patients.MethodsWe reviewed records from patients in our critical care units, comparing anticoagulation parameters with clinical outcomes. Statistical analyses included the Wilcoxon rank sum test for continuous variables and chi-square or Fisher's exact tests for categorical variables. We used Kaplan-Meier curves to depict hemorrhage incidence and logistic regression to identify factors associated with bleeding and mortality. Linear regression assessed coagulation factors linked to length of stay (LOS).ResultsOf 76 patients, 32 (42.1%) experienced hemorrhage; 15 (46.9%) of these survived. Survivors had a higher proportion without bleeding (68.2%). Hemorrhage patients had more circuit changes (18.8% vs 2.3%, p = .01). The 10-, 20-, and 30-days cumulative hemorrhage incidences were 36.9%, 58.8%, and 72.5%, respectively. Multivariable analysis suggested that bleeding patients had a higher aPTT prior to the bleeding event compared with the median aPTT in non-bleeding patients (p = 0.04), and ACT and PT levels showed a trend towards a significant association (p = 0.06). Longer ECMO runs and circuit changes increased hemorrhage risk (OR = 1.004 and OR = 12.85, respectively).ConclusionOur study found that higher aPTT and longer ECMO duration are independent hemorrhage risk factors, underscoring the need for timely ECMO decannulation.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1260-1270"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960503","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":"Continuous or intermittant retrograde cardioplegia during coronary bypass: A propensity score adjusted comparison.","authors":"Kemal Uzun, Muhammet Onur Hanedan, Hakan Kara, Selma Fiş Topaloğlu","doi":"10.1177/02676591261416083","DOIUrl":"10.1177/02676591261416083","url":null,"abstract":"<p><p>IntroductionContinuous retrograde cardioplegia worsens surgeon's vision while performing distal anastomosis in coronary artery bypass grafting operations. We investigated whether intermittent retrograde cardioplegia, which provides a bloodless surgical field by interrupting cardioplegia flow during distal anastomosis, poses a disadvantage in terms of myocardial protection.MethodsThis retrospective study was conducted in two different heart centres between January 2013 and July 2023. A total of 234 patients who underwent ≥2 target vessel revascularization under cardiopulmonary bypass were examined. Isothermic, potassium-enriched blood cardioplegia was used and induction was performed antegrade in all patients. In addition to antegrade, we routinely gave retrograde cardioplegia. Retrograde cardioplegia was applied continuously with the force of gravity in the continuous group (<i>n</i> = 167), and intermittently with pressure in the intermittent group (<i>n</i> = 167).ResultsThe volume of cardioplegia solution administered was significantly higher in the intermittent group compared to the continuous group (4070 ± 760 mL vs 3190 ± 575 mL; <i>p</i> = 0.001). However, no significant differences were observed between the groups regarding postoperative clinical outcomes or early mortality rates.ConclusionsIntermittent retrograde cardioplegia offers superior operative conditions by ensuring a bloodless surgical field and improved procedural comfort, while maintaining equivalent efficacy in myocardial protection compared with the continuous method.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1246-1250"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935891","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":"Peripheral veno-arterial ECMO cannulation in children: Review of the relevant ELSO publications.","authors":"Jana Assy, Matteo Di Nardo, Issam El Rassi","doi":"10.1177/02676591251407295","DOIUrl":"10.1177/02676591251407295","url":null,"abstract":"<p><p>BackgroundPeripheral veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) cannulation in children poses a significant clinical challenge due to wide variations in body size, vessel caliber, and risk profiles.PurposeThis literature review examines current cannulation practices in pediatric patients.Research design Study sample & Data collectionThe study analyzed large datasets from the Extracorporeal Life Support Organization (ELSO) registry, focusing on neurologic and limb complications associated with carotid versus femoral artery use.ResultsDespite general recommendations favoring carotid cannulation in children under 15-20 kg and femoral access in larger, ambulatory patients, ELSO data show a persistent reliance on carotid cannulation even in older children. In four major ELSO studies, carotid use ranged from 45% to 94% among children over 5 years of age. Neurologic complication rates varied widely, from 7% to 23%, with some studies linking carotid access to higher risk of CNS injury, while others found no significant difference. Femoral cannulation, although theoretically safer neurologically, carried notable risks of limb ischemia-reported between 7.5% and 20%-and potential need for vascular interventions or amputations.ConclusionsThis review highlights the lack of standardized practice and the influence of local expertise, anatomical variability, and data limitations. It also underscores the need for clearer definitions and better reporting in future studies. While carotid cannulation remains prevalent across age groups, growing evidence of limb complications with femoral access invites reconsideration of the \"transition point\" in pediatric ECMO cannulation strategies. Until more definitive data emerge, individualized decision-making guided by patient characteristics and institutional experience remains essential.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1087-1096"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702804","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":"Securing data management systems in perfusion: A narrative review on cybersecurity and clinical risk.","authors":"Youssef El Dsouki, Ignazio Condello, Calogero Iacona, Samir El Daccache, Roberto Lorusso","doi":"10.1177/02676591261417526","DOIUrl":"10.1177/02676591261417526","url":null,"abstract":"<p><p>BackgroundThe increasing digitization of perfusion practice has led to the integration of advanced data management systems (DMS) that record and analyze intraoperative variables in real time. While these systems improve accuracy, traceability, and clinical decision-making, they also expose perfusion workflows to significant cybersecurity risks. Given that perfusion data directly reflect artificial circulation, any loss of integrity or service can have immediate clinical consequences.Materials and MethodsA comprehensive narrative review was conducted to synthesize current knowledge on cybersecurity in perfusion informatics and performance. The research strategy combined systematic database searches (PubMed, Scopus, IEEE Xplore, and Web of Science) with targeted grey literature review (regulatory frameworks and institutional reports). Inclusion criteria focused on articles published between 2010 and 2024 addressing healthcare cybersecurity, perfusion informatics, and medical device security. Studies were analyzed qualitatively to identify recurring themes, technological approaches, and governance models. Reference cross-checking ensured comprehensive coverage, and terminology was standardized according to ISO/IEC 27001 principles. The review followed an integrative, non-meta-analytic design, emphasizing conceptual synthesis rather than statistical aggregation.ResultsThirty-three primary and secondary sources were identified. The literature reveals a consistent pattern of vulnerabilities across clinical DMS, with perfusion systems being particularly exposed to ransomware, data tampering, and service interruption. The review highlights the centrality of the Confidentiality-Integrity-Assurance of Service triad as a guiding model. Key strategies identified include encryption and role-based access control, blockchain audit trails, federated learning, and post-quantum cryptography. However, empirical studies focusing specifically on perfusion remain scarce, underscoring a major research gap.ConclusionsCybersecurity in perfusion informatics must evolve from a technical adjunct to a clinical mandate. Integrating security frameworks into perfusion workflows supported by legal compliance (HIPAA, GDPR, ISO 27001) and ethical governance is essential to preserve patient safety. Future research should prioritize multicenter simulations, resilience testing, and cross-disciplinary training to ensure the continuity, integrity, and trustworthiness of digital perfusion systems.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"1105-1113"},"PeriodicalIF":1.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953749","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":"The dawn of ECMO in Europe.","authors":"Gösta Mellgren, Lars Göran Friberg","doi":"10.1177/02676591261485082","DOIUrl":"https://doi.org/10.1177/02676591261485082","url":null,"abstract":"","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261485082"},"PeriodicalIF":1.3,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076518","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":"Membrane lung dead space and membrane lung impairment: An exploratory retrospective study in COVID-19 patients.","authors":"Giovanni Lino, Matteo Rossetti, Guido Capitanio, Sara Coppolecchia, Giovanna Occhipinti, Rosalia Longo, Fabio Tuzzolino, Antonio Arcadipane, Gennaro Martucci, Marta Velia Antonini, Roberto Lorusso, Giovanna Panarello","doi":"10.1177/02676591261487320","DOIUrl":"https://doi.org/10.1177/02676591261487320","url":null,"abstract":"<p><p>BackgroundVeno-venous extracorporeal membrane oxygenation (VV ECMO) is a key therapy for refractory respiratory failure, but can trigger systemic inflammation and prothrombotic activation that impair the membrane lung (ML). ML dysfunction can lead to mechanical failure of extracorporeal support, severe hypoxemia, and the need for urgent or elective circuit replacement. Conventional single parameters (pressure drop, post-ML blood gases, hemoglobin saturation), and laboratory tests have limited ability to predict ML deterioration.MethodsWe conducted a single-center pilot retrospective study including 27 ECMO circuits from 20 adult patients with COVID-19-related acute respiratory failure. Membrane lung dead space (DS_ML) was calculated from ML exhaust carbon dioxide (CO₂) and blood gas measurements and used to assess ML effectiveness. For each circuit we evaluated the association between DS_ML and subsequent circuit exchange.Results20 patients (27 ECMO circuits) were analyzed; 10 circuits required replacement. Circuits that were replaced showed higher DS_ML values and lower CO₂ concentration in membrane lung exhaust gas and membrane lung CO₂ removal compared with circuits that completed the run. CO₂-derived variables were the only parameters that differed significantly between groups, while oxygenation-related measures and baseline characteristics were similar.ConclusionsIn this exploratory study conducted on COVID-19 patients, we found an association between DS_ML increase and membrane lung impairment. However, the analysis does not provide enough information to assess the predictive performance of DS_ML. The identification of a significant threshold for circuit exchange requires further validation in larger prospective and multicenter studies.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261487320"},"PeriodicalIF":1.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031455","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":"Predictive monitoring of venous reservoir level fluctuations and rapid depletion during CPB via real-time image analysis.","authors":"Tomotaka Shinohara, Takeshi Matsumoto, Taishi Furukawa, Masami Sana, Kazuyuki Tanaka, Satoshi Kuroda, Kiyoshi Yoshida, Takayoshi Ueno","doi":"10.1177/02676591261489051","DOIUrl":"https://doi.org/10.1177/02676591261489051","url":null,"abstract":"<p><p>BackgroundOperating a cardiopulmonary bypass (CPB) system requires high-level multitasking while simultaneously maintaining continuous situation awareness. Among these, venous reservoir level is particularly critical. This level is monitored using sensors fixed to arbitrary positions on the reservoir. When a sudden drop in level, the rate of decline accelerates. Conventional sensor threshold settings do not allow sufficient time for the operator to recognize the danger and intervene, so a means of detecting dangerous drops in level earlier is necessary.ObjectiveThe purpose of this study was to develop a system that can detect a sudden drop in liquid level early, regardless of the shape of the reservoir, based on image analysis using a webcam and mathematical models, and to verify its effectiveness.MethodsWe used a webcam to quantify the level fluctuation rate in two types of venous reservoirs (Manufacturer T and Manufacturer M) with different shapes, and predicted level fluctuations from the resulting mathematical model. We further developed a system that uses the reservoir level fluctuation rate as a threshold. This system predicts dangerous situations based on the rate of level decline caused by poor drainage or massive bleeding of unknown cause, and issues alerts and alarms.ResultsThe rate of reservoir drawdown accelerated below the intermediate reservoir level. Our proposed method triggered a danger alarm an average of 7 s earlier (Manufacturer T) and 2 seconds earlier (Manufacturer M) than the conventional method (300 mL threshold).ConclusionsThe efficacy of an early warning system that issues alerts in advance of the conventional volume-based threshold was demonstrated by utilizing the slope (rate of change) of the level decline as the detection threshold. Implementation of this system may improve the safety of extracorporeal circulation and reduce the burden on the operator during cardiopulmonary bypass procedures.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261489051"},"PeriodicalIF":1.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031703","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":"Impact of left common carotid cannula design on flow distribution and cerebral perfusion pressure during bilateral selective antegrade cerebral perfusion: An experimental and computational study.","authors":"Petter Holmlund, Julia Servin, Axel Vikström, Martha Johannesdottir, Laleh Zarrinkoob, Jan Hellström, Micael Appelblad","doi":"10.1177/02676591261489044","DOIUrl":"https://doi.org/10.1177/02676591261489044","url":null,"abstract":"<p><p>BackgroundIn aortic arch surgery, bilateral selective antegrade cerebral perfusion (bSACP) maintains cerebral blood flow during circulatory arrest. bSACP is often delivered using a single pump with a Y-connector, dividing the flow. Current practice has veered towards perfusion of the left common carotid artery by cannula and the right subclavian artery by a vascular graft. Flow distribution may therefore depend on left-sided cannula resistance, particularly in patients with limited collateral circulation. We investigated how cannula design influences perfusion pressure and flow distribution during bSACP.MethodsFour clinically available carotid perfusion cannulas were characterized using bench measurements (40-200 mL/min) and computational fluid dynamics (CFD). The resulting resistance models were integrated into patient-specific CFD models of the cerebral circulation in three patients with varying collateral capacity. Both flow- and pressure-targeted perfusion strategies were simulated.ResultsBench testing demonstrated a 3-4-fold difference in flow resistance between the lowest- and highest-resistance cannulas, which was accurately reproduced in CFD simulations. Importantly, resistance did not correlate with nominal French size. In the patient-specific CFD models, increasing left side cannula resistance roughly doubled the pressure laterality (7-9 to 14-23 mmHg) and halved the left side inflow (135-160 to 70-100 mL/min) for the cannulas tested. Effects were most pronounced in patients with limited collateral circulation. Sensitivity analyses confirmed robustness across physiological and geometric perturbations.ConclusionsCannula resistance does not correlate with nominal French size. Cannula design may influence cerebral perfusion pressure and flow distribution during bSACP and may warrant increased attention.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261489044"},"PeriodicalIF":1.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002437","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":"Successful management of acute respiratory distress syndrome secondary to type A aortic dissection using venovenous oxygenation: A case report.","authors":"Kazuhisa Hamada, Tomoaki Fujii","doi":"10.1177/02676591261489055","DOIUrl":"https://doi.org/10.1177/02676591261489055","url":null,"abstract":"<p><p>IntroductionType A aortic dissection (AD) rarely coexists with acute respiratory distress syndrome (ARDS). Venovenous (VV) extracorporeal membrane oxygenation (ECMO) is avoided owing to bleeding and dissection progression concerns.Case ReportA 49-year-old man presented with sudden onset of chest pain and dyspnea. Computed tomography findings did not indicate rupture or malperfusion in Type A AD. He developed severe ARDS refractory to lung-protective ventilation and recruitment maneuvers. VV-ECMO was initiated with nafamostat anticoagulation, with temporary continuous hemodiafiltration for fluid balance. Oxygenation improved, allowing ECMO removal on Day 14. After tracheostomy, he was discharged from the ICU on Day 49 and mechanically ventilated without AD progression.DiscussionVV-ECMO can stabilize gas exchange without exacerbating AD in select patients with ARDS when perioperative risk outweighs the immediate risk of rupture or organ malperfusion.ConclusionVV-ECMO may be considered for ARDS complicated AD when the bleeding risk is mitigated by regional anticoagulation.</p>","PeriodicalId":49707,"journal":{"name":"Perfusion-Uk","volume":" ","pages":"2676591261489055"},"PeriodicalIF":1.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978636","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}