Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery最新文献

{"title":"A Study on the Impact of the COVID-19 Pandemic on the Aetiology of Paediatric Olfactory Dysfunction.","authors":"Matthias Deller, Valentin A Schriever, Thomas Hummel","doi":"10.1159/000537835","DOIUrl":"10.1159/000537835","url":null,"abstract":"<p><strong>Introduction: </strong>Although previous studies have examined olfactory dysfunction in children, the novel coronavirus SARS-CoV-2 has certainly had an unprecedented effect on their olfaction, which could not be taken into consideration. The aim of this report was to present data on the epidemiology of olfactory dysfunction during the pandemic and compare this dataset with a pre-pandemic set. We hypothesized an increase in URTI-related olfactory dysfunction.</p><p><strong>Methods: </strong>Data of paediatric patients consulting a smell and taste clinic between March 2020 and June 2022 were retrospectively analysed. The frequency of major causes of olfactory dysfunction was examined and compared with three subsets of an older dataset.</p><p><strong>Results: </strong>A total of 52 patients were included in the analysis. Most children presented with olfactory dysfunction due to upper respiratory tract infection (URTI) (52%). Congenital olfactory dysfunction was present in 34% of cases. Sinonasal disorders and idiopathic cases accounted for 6 and 4%, respectively, whereas head trauma was the least common cause (2%). This was in contrast with the results of the older set. The frequency of URTI-related olfactory dysfunction increased significantly. The frequency of head-trauma-related or congenital olfactory dysfunction showed marked reductions. There were no significant differences regarding the other aetiologies between our patient cohort and the three subsets.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic has resulted in differences regarding the prevalence of aetiologies between our dataset and the subsets of pre-pandemic times. The surge of the frequency of URTI-related olfactory dysfunction may be ascribed to a novel pathomechanism involving sustentacular cells in the olfactory epithelium.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"65-72"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867969","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":"Efficacy of Cetuximab Combined with Paclitaxel in Patients with Recurrent Salivary Gland Carcinoma: A Retrospective Observational Study.","authors":"Ryosuke Sato, Ryota Yuasa, Takumi Kumai, Risa Wakisaka, Hiroki Komatsuda, Michihisa Kono, Hidekiyo Yamaki, Yoshiya Ishida, Tetsuji Wada, Miki Takahara, Akihiro Katada","doi":"10.1159/000534516","DOIUrl":"10.1159/000534516","url":null,"abstract":"<p><strong>Introduction: </strong>Due to the rarity and various histological types, a standard chemotherapy regimen for recurrent or metastatic salivary gland carcinoma (SGC) has not been established. Molecular-targeted therapy is a novel cancer therapy based on the expression of target molecules. However, few molecular-targeted therapy types have shown satisfactory efficacy for patients with SGC. Our study described promising results of epidermal growth factor receptor (EGFR)-targeting therapy with paclitaxel in patients with SGC.</p><p><strong>Methods: </strong>The medical records of patients with recurrent SGC treated with weekly cetuximab combined with paclitaxel (Cmab-PTX) between December 2017 and December 2022 at our institutions were retrospectively analyzed.</p><p><strong>Results: </strong>Seven patients with SGC received Cmab-PTX therapy. The median age was 76 years. All patients were high-grade histological types, and EGFR expression was positive in all examined patients. Cmab-PTX was administered for a median period of 20 months (range of 2-36 months). The overall responses were three with complete response, two with partial response, one with stable disease (&gt;24 weeks), and one with progressive disease. The objective response and disease control rates were 71.4% and 85.7%, respectively. Progression-free survival ranged between 2 and 36 months (median 12 months), whereas overall survival ranged between 4 and 111 months (median 36 months). One patient experienced a grade 4 adverse event (neutropenia), which was conservatively manageable.</p><p><strong>Conclusion: </strong>Although the treatment sensitivity of SGC with high-grade histological types is usually poor, Cmab-PTX could be a promising treatment regimen for recurrent SGC. Due to the rarity and various histological types, a standard chemotherapy regimen for recurrent or metastatic salivary gland carcinoma (SGC) has not been established. Molecular-targeted therapy is a novel cancer therapy based on the expression of target molecules. However, few molecular-targeted therapy types have shown satisfactory efficacy in patients with SGC. Our study described promising results of cetuximab (Cmab), epidermal growth factor receptor (EGFR)-targeting therapy with paclitaxel (PTX) in patients with SGC. Seven patients with SGC received Cmab-PTX therapy. The median age was 76 years. All patients were high-grade histological types, and EGFR expression was positive in all examined patients. Cmab-PTX was administered for a median period of 20 months. The overall responses were three with complete response, two with partial response, one with stable disease (&gt;24 weeks), and one with progressive disease. The objective response rate was 71.4%. Progression-free survival ranged between 2 and 36 months (median 12 months), whereas overall survival ranged between 4 and 111 months (median 36 months). One patient experienced a grade 4 adverse event (neutropenia), which was conservatively manageable. ","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"41-49"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801813","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":"Management of Implant Extrusion following Thyroplasty for Vocal Fold Paralysis: A Case Report.","authors":"Barbara Konjević, Andro Košec, Mirta Peček, Siniša Stevanović","doi":"10.1159/000533812","DOIUrl":"10.1159/000533812","url":null,"abstract":"<p><p>The most widely used laryngeal surgery technique for patients with vocal fold paralysis is medialization thyroplasty. Materials such as Gore-Tex, silastic, and hydroxyapatite are often used, and the most worrisome possible complication is extrusion of the implant. A 36-year-old female patient with a history of pediatric cardiac surgery was diagnosed with left vocal cord paralysis after an episode of upper respiratory infection with a working diagnosis of subclinical left vocal cord paralysis following cardiac surgery. She underwent medialization thyroplasty with a Gore-Tex implant under local anesthesia. On the 21st postoperative day, she presented with sudden-onset hoarseness and dysphagia due to Gore-Tex implant extrusion. The implant was removed and augmentation of the left vocal cord with adipose tissue was performed. Only 14 cases of Gore-Tex implant extrusion have been described in the literature so far. The aim of this case report was not only to show one possible complication when using a Gore-Tex implant but also to present fat augmentation as one of the solutions for revision medialization and salvage treatment, with sustained long-term results.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"50-53"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41217881","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":"Temporal Development of Depression and Anxiety in a Large Facial Palsy Cohort.","authors":"Sandhya Kalavacherla, Michael Oca, Eric Du, Leo Meller, Víctor de Cos, Benjamin T Ostrander, Jacqueline J Greene","doi":"10.1159/000539183","DOIUrl":"10.1159/000539183","url":null,"abstract":"<p><strong>Introduction: </strong>Diagnosis with facial palsy (FP) has been linked to increased psychosocial distress and communication disorders, but limited data exist on the temporal development of depression and anxiety after diagnosis. In a large cohort of FP patients, we characterize the rates of depression and anxiety at several timepoints post-FP diagnosis.</p><p><strong>Methods: </strong>A de-identified database of all FP patients who presented to a single healthcare system over 22 years was created using Epic SlicerDicer. Demographics and comorbidities were collected and depression and anxiety diagnosis rates at three timepoints (non-inclusive lower bounds) post-FP diagnosis were examined.</p><p><strong>Results: </strong>3,910 FP patients were identified, with a median age of 59. 56% were female and 51% were white. At 0-6, 6-12-, and 12-36-month post-FP diagnosis, 156 (4%), 58 (1.4%), and 205 (5.2%) individuals were diagnosed with depression, and 171 (4.4%), 84 (2.1%), and 237 (6.1%) were diagnosed with anxiety. At each time point, the median time between FP and depression diagnosis (2.1, 3.4, and 11.4 months) or anxiety diagnosis (2.5, 4.0, and 11.1 months) was similar. Dual depression and anxiety diagnoses were observed in 52 (1.3%), 32 (0.8%), and 122 (3.1%) patients at each time point. Compared to the overall cohort, more patients with anxiety were female (65 vs. 56%, p < 0.001) and younger (57 vs. 59, p = 0.002), and more depressed patients were Black (7.3 vs. 3.3%, p = 0.02).</p><p><strong>Conclusions: </strong>Facial palsy may lead to increased risk of depression and/or anxiety in the first year after diagnosis as demonstrated here in one of the largest FP cohorts to date. We report high rates of depression (5.5%), anxiety (6.5%), and comorbid depression and anxiety (2.1%) occurring within 1 year after FP diagnosis. Of these, the majority occurred within the first 6 months (72%, 67%, 62%, respectively). Anxiety was more common in young female patients and depression more common in Black patients, which can inform targeted mental health resources within the first 6 months post-FP diagnosis.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"151-156"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860989","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":"Front & Back Matter","authors":"Mihir R. Patel, Fernando Luiz Dias, Daqing Li, Thomas Linder, S. Malekzadeh","doi":"10.1159/000531360","DOIUrl":"https://doi.org/10.1159/000531360","url":null,"abstract":"","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":"189 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77369215","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":"Characterizing Adverse Events of Biologic Treatment of T2 Disease: A Disproportionality Analysis of the FDA Adverse Event Reporting System.","authors":"Taylor J Stack, Sulgi Kim, Meredith M Lamb, Ibtisam Mohammad, Abdullah Zeatoun, Erin Lopez, Cristine Klatt-Cromwell, Brian D Thorp, Charles S Ebert, Brent A Senior, Adam J Kimple, Daniel Alicea","doi":"10.1159/000534545","DOIUrl":"10.1159/000534545","url":null,"abstract":"<p><strong>Introduction: </strong>Over the last 3 years, the FDA has approved dupilumab, omalizumab, and mepolizumab for the treatment of CRSwNP; however, adverse events of these biologics have not been described in post-marketing surveillance trials. By utilizing the FDA Adverse Event Reporting System (FAERS), this study describes and compares biologic-associated adverse events in T2 disease.</p><p><strong>Methods: </strong>This case-non-case study assessed disproportionate reporting rates using reporting odds ratios (RORs). RORs and p values for biologic-associated AEs were categorized and compared among dupilumab, omalizumab, and mepolizumab. This analysis included AEs associated with all treatment indications. Relative AE rates and outcomes were calculated.</p><p><strong>Results: </strong>There were a total of 112,560, 24,428, and 18,741 unique AE reports associated with dupilumab, omalizumab, and mepolizumab, respectively. Omalizumab had the strongest association with anaphylaxis (ROR = 20.80, 95% confidence interval [CI]: 18.58, 23.29). Dupilumab had large relative proportions and positive signals in the ophthalmologic category (7.76%, ROR = 6.20, 95% CI: 6.06, 6.35), such as with blurry vision (ROR = 3.80, CI: 3.52, 4.12) and visual impairment (ROR = 1.98, CI: 1.80, 2.19). Dupilumab was the only biologic associated with injection-site reactions (7.98%, ROR = 8.17, 95% CI: 7.98, 8.37).</p><p><strong>Discussion/conclusion: </strong>This is the first large-scale comparative analysis of the AE profiles of dupilumab, omalizumab, and mepolizumab. Our data suggest possible relations between dupilumab and ophthalmologic and injection-site AEs. Omalizumab was the only biologic with a positive anaphylaxis signal. This FAERS investigation suggests important AE differences among these biologics.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":" ","pages":"329-339"},"PeriodicalIF":1.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10842062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107592589","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":"Osteosarcoma in the Thyroid Gland.","authors":"Bobby Ijeoma,&nbsp;Vaidehi Avadhani,&nbsp;Stephanie Zheng,&nbsp;Charles Moore","doi":"10.1159/000525183","DOIUrl":"https://doi.org/10.1159/000525183","url":null,"abstract":"<p><p>Primary osteosarcomas are rarely seen in areas other than bone, although they can occur in sites such as the thigh, anal region, hand, etc. We present a case of primary extraskeletal osteosarcoma of the thyroid, of which there are only 29 previous reported cases. Presentations and treatment options for this type of tumor vary. Through this case report, we discuss the similarities and differences of the patient's presentation compared with other documented cases, imaging, the rationale behind treatment, and the current clinical course.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":"85 1","pages":"52-56"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10642067","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 Patterns and Prognosis of Patients with Sinonasal Carcinoma: A Population-Based Study.","authors":"Zhenzhang Lu,&nbsp;Liqing Chen,&nbsp;Yongtian Lu,&nbsp;Zhimin Zhao,&nbsp;Guohui Nie","doi":"10.1159/000526164","DOIUrl":"https://doi.org/10.1159/000526164","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to summarize the incidence, risk factors, and prognostic factors of distant metastasis of sinonasal carcinoma.</p><p><strong>Methods: </strong>We collected data for patients diagnosed with sinonasal carcinoma from 2010 to 2015 from the SEER database and analyzed the risk factors for distant metastasis via univariate and multivariate logistic regression analysis. In addition, univariate and multivariate Cox regression analysis models were used to describe the factors related to the overall survival of patients with distant metastasis.</p><p><strong>Results: </strong>A total of 2,255 patients were included in the study, including 86 in the distant metastasis group and 2,169 in the nondistant metastasis group. In the univariate and multivariate logistic regression analyses, we found that the risk factors affecting distant metastasis were poorly differentiated tumor grade (HR = 1.932, 95% CI: 1.082-3.452, p = 0.026), advanced T stage (T3-T4) (HR = 4.302, 95% CI: 2.047-9.039, p < 0.001), and advanced N stage (HR = 3.093, 95% CI: 1.911-5.005, p < 0.001). Moreover, elderly patients had a poorer prognosis than young patients (HR = 1.792, 95% CI: 1.096-2.931, p = 0.02) and that surgical treatment improved the survival rate of tumor patients with distant metastasis (HR = 0.450, 95% CI: 0.247-0.821, p = 0.009).</p><p><strong>Conclusion: </strong>Tumor grade, T stage, and N stage are risk factors for distant metastasis in sinonasal carcinoma, while an age of less than 65 years and surgery were positive prognostic factors for sinonasal carcinoma patients with distant metastasis.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":"85 1","pages":"44-51"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10643697","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":"Management of Chronic Sialadenitis due to Sjogren's Syndrome and Radioactive Iodine Therapy Using Sialendoscopy.","authors":"Jennifer E Douglas,&nbsp;Christopher Z Wen,&nbsp;W Walsh Thomas,&nbsp;Mohamed Elrakhawy,&nbsp;Christopher H Rassekh","doi":"10.1159/000525217","DOIUrl":"https://doi.org/10.1159/000525217","url":null,"abstract":"<p><strong>Introduction: </strong>Sialendoscopy is a minimally invasive technique for the management of salivary gland disease. This work characterizes its utility for treating chronic sialadenitis due to Sjogren's syndrome and radioactive iodine (RAI) therapy.</p><p><strong>Methods: </strong>A single-center, retrospective review of patients undergoing sialendoscopy between March 2013 and May 2019 for the treatment of chronic sialadenitis due to Sjogren's or prior RAI therapy was performed.</p><p><strong>Results: </strong>Thirty-four patients with Sjogren's and 25 patients who received RAI were identified, undergoing a total of 86 procedures. Median age at presentation was 53 years with mean follow-up time of 14.3 months. Seventy-two procedures were performed on the parotid gland, four on the submandibular gland, and ten on both glands. Corticosteroid injection and duct dilation were performed most commonly. Sixteen patients required repeat procedure. All patients were symptomatically improved at follow-up visit.</p><p><strong>Discussion/conclusion: </strong>These results support the idea that sialendoscopy offers symptomatic benefit for patients with chronic sialadenitis due to Sjogren's or RAI.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":"85 1","pages":"7-11"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10645007","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":"Safe Limits of Lateral Nasal Wall Osteotomy at Le Fort I Surgery.","authors":"Muazzez Suzen,&nbsp;Mustafa Temiz,&nbsp;Kadir Cesur,&nbsp;Sina Uckan","doi":"10.1159/000528512","DOIUrl":"https://doi.org/10.1159/000528512","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to define the difference between lateral nasal wall anatomy and variations as linear and angular in patients with class II and class III dentofacial deformities and to determine a surgical margin for safe entry by establishing an ideal osteotomy line for lateral nasal wall osteotomy during Le Fort I surgery.</p><p><strong>Materials and methods: </strong>Eighty-five patients with dentofacial deformities, who were admitted to Medipol Mega University Hospital between September 2018 and February 2021, and 170 regions, including the right and left, were evaluated. In the axial image taken from coronal sections 5 mm above the deepest point of the nasal floor, lateral nasal wall angulations and linear and angular distances to the descending palatine canal were measured. Class II and class III patients were evaluated according to the right and left regions and gender.</p><p><strong>Results: </strong>The angled right distance values to the descending palatine artery of class III patients are higher than the values of the angled left distance to the descending palatine canal (p = 0.034). The right second angulation levels of class II female patients are higher than those of class II male patients (p = 0.037). Class III male patients have a significantly higher right linear distance to the descending palatine canal and right second angulation levels compared to class III female patients (p1 = 0.009; p2 = 0.003). The right second angulation levels of class II male patients are significantly lower than those of class III male patients (p = 0.003).</p><p><strong>Conclusion: </strong>This study described the mean angulations and linear distances between anatomic structures of the lateral nasal wall in patients with class II and class III dentofacial deformities for the purpose of a safe osteotomy. The location of the descending palatine canal and the morphology of the lateral nasal wall are not significantly associated with dentofacial deformity.</p>","PeriodicalId":49717,"journal":{"name":"Orl-Journal for Oto-Rhino-Laryngology Head and Neck Surgery","volume":"85 2","pages":"97-103"},"PeriodicalIF":1.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9998093","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}