Medicc Review最新文献

{"title":"Potential Heart Problems in Convalescent COVID-19 Children: Alert from a Cuban Study.","authors":"Lisset Ley-Vega","doi":"10.37757/MR2021.V23.N2.13","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N2.13","url":null,"abstract":"Although children with COVID-19 are often asymptomatic or exhibit only mild symptoms, they can transmit the disease and suffer from serious manifestations. In Cuba, 2932 patients ≤18 years old tested positive for COVID-19 between March 2020 and February 1, 2021. Most of these children presented few to no symptoms upon diagnosis. At the time of this writing, 82.8% of those children had recovered,[1] and there had not been a single pediatric death due to the novel coronavirus.","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 2","pages":"76"},"PeriodicalIF":2.1,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38969322","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":"Persons with Substance Abuse Disorders and Other Addictions: Coping with the COVID-19 Pandemic.","authors":"Justo R Fabelo-Roche,&nbsp;Serguei Iglesias-Moré,&nbsp;Ana M Gómez-García","doi":"10.37757/MR2021.V23.N2.2","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N2.2","url":null,"abstract":"<p><p>Cuba implemented policies mandating social distancing on March 11, 2020, which were still in place at the time of this study. During such periods of isolation, people with psychoactive substance-related disorders and other addictions may be tempted to reduce tension, stress, uncertainty and possible distress by increasing the use of substances or practices they have abused. This can mean relapses and setbacks for patients undergoing treatment. A multidisciplinary team of health professionals specializing in addiction at the Center for Academic Development in Drug Addiction, in Havana, Cuba, cares for people with these disorders and followed their evolution during the initial period of COVID-19 social isolation. With the aim of characterizing strategies employed by patients undergoing treatment for substance abuse and addictions, we conducted a qualitative study from April 2020 through May 2020, using a convenience sample of 37 patients (all students) who had been progressing towards recovery from addictive behaviors when face-to-face encounters were suspended due to COVID-19 restrictions. Contact was maintained through information and communication technologies. The research used telepsychology and focused on understanding patient life experiences. Patients were interviewed using a semi-structured survey, which was then transcribed and coded thematically using a grounded-theory approach. We found that patients' ability to cope successfully with challenges presented by COVID-19 were influenced by: 1) the individual's own methods for maintaining self-control (commitment to studies, projects, and work with therapists) that aided them in their goals concerning abstinence; 2) difficulties faced in addressing specific events and situations (doubts, uncertainties, disagreements, isolation and time use); 3) perpetuation and revivification of myths related to substances and addictive activities (exacerbation of supposed benefits of tobacco, alcohol, marijuana, overuse of social networks); and 4) tendencies toward irrationality and lack of emotional control (fear, sadness, anger, constant worry and self-imposed demands). Our findings suggest that despite the potential negative psychological impact of preventive social isolation during the COVID-19 pandemic, individual coping mechanisms developed by these patients, aiming at improved self-control, allowed most to avoid setbacks that could have affected their recovery. Nevertheless, patients faced challenges to their recovery that were compounded by difficulties in specific situations, myths related to substances and addictive activities, and tendencies toward irrationality or lack of emotional control.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 2","pages":"55"},"PeriodicalIF":2.1,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38900850","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":"Genodermatoses in Las Tunas Province, Cuba, 1989-2019.","authors":"Yordania Velázquez-Ávila,&nbsp;Carmen R Valenciano-Rodríguez","doi":"10.37757/MR2021.V23.N2.10","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N2.10","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;INTRODUCTION Genodermatoses are a group of genetic diseases that affect the skin and adjoining tissues. They represent 15% of genetic diseases worldwide. Cuba established a National Program for the Diagnosis, Care and Prevention of Genetic Diseases and Congenital Abnormalities in 1980, which was implemented in Las Tunas in 1989. In 2010, a specialized multidisciplinary provincial service for genodermatoses patients was established in Las Tunas province. Several studies in Las Tunas show that genodermatoses represent 22.2% of genetic diseases; the most common are ichthyosis (16.7%), mastocytosis (11.7%), and neurofibromatosis (8.3%). Children aged &lt;12 years are the most affected (61.6%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Describe genodermatoses in Las Tunas Province, Cuba, since the implementation of the National Program for the Diagnosis, Care, and Prevention of Genetic Diseases and Congenital Abnormalities, and after the creation of a specialized multidisciplinary provincial service for genodermatoses patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted an observational, descriptive, retrospective study in 249 patients diagnosed with some type of genodermatosis who received care in Las Tunas during 1989-2019. Variables considered were: type of genodermatosis, complications, deaths and geographic location by municipality. We studied prevalence rates (1989-2019), incidence rates (2010-2019), proportion of complications, survival rates, and types of genodermatosis diagnosed by municipality in two periods (1989-2009 and 2010-2019) one before, and one after the implementation of a targeted multidisciplinary provincial care service.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The general prevalence rate of genodermatoses in Las Tunas Province was 46.51 per 100,000 population. The forms with the highest prevalence rates were neurofibromatosis type 1 (13.6 per 100,000 population), classical Ehlers-Danlos syndrome (7.1 per 100,000), ichthyosis vulgaris (5.0 per 100,000) and cutaneous mastocytosis (2.4 per 100,000). The highest incidence rates coincided with the conditions with the highest prevalence: neurofibromatosis type 1 (81.5 per 1000 cases in 2013), classical Ehlers-Danlos syndrome (44.4 per 1000 cases in 2013) and ichthyosis vulgaris (52 per 1000 cases in 2010). From 1989-2009, patients presented a greater frequency of complications, at 40% (22/55) than from 2010-2019 at 21.1% (41/194). Pyodermitis was the most common during the study period (1989-2019), with 29.1% (16/55). Survival was high, at 98.0% (only 5 deaths in 2009, 2010, 2011, 2012, and 2015, and were no deaths during other years) in the study period. The greatest share of genodermatosis cases was registered in the municipality of Majibacoa (0.07%), and consanguinity was found in cases of epidermolysis bullosa, Herlitz type and xeroderma pigmentosum.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In Las Tunas Province, Cuba, genodermatoses as a whole are not rare diseases. Th","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 2","pages":"34"},"PeriodicalIF":2.1,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38900843","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":"Implications of Low-grade Inflammation in SARS-CoV-2 Immunopathology.","authors":"Anamary Suárez-Reyes,&nbsp;Carlos A Villegas-Valverde","doi":"10.37757/MR2021.V23.N2.4","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N2.4","url":null,"abstract":"<p><strong>Introduction: </strong>Advanced age and chronic disease comorbidities are indicators of poor prognosis in COVID-19 clinical progression. Fatal outcomes in patients with these characteristics are due to a dysfunctional immune response. Understanding COVID-19's immunopathogenesis helps in designing strategies to prevent and mitigate complications during treatment.</p><p><strong>Objective: </strong>Describe the main immunopathogenic alterations of COVID-19 in patients of advanced age or with chronic non-communicable diseases.</p><p><strong>Data acquisition: </strong>We carried out a bibliographic search of primary references in PubMed, Elsevier, Science Direct and SciELO. A total of 270 articles met our initial search criteria. Duplicate articles or those unrelated to at least one chronic comorbidity, senescence or inflammation and those that studied only patient clinical characteristics, laboratory tests or treatments were excluded. Finally, our selection included 124 articles for analysis: 10 meta-analyses, 24 original research articles, 67 review articles, 9 editorials, 9 comments, 3 books and 2 websites.</p><p><strong>Development: </strong>Hypertension and diabetes mellitus are the most common comorbidities in COVID-19 patients. Risk of developing severe manifestations of the disease, including death, is increased in senescent and obese patients and those with cardiovascular disease, cancer or chronic obstructive pulmonary disease. Low-grade chronic inflammation is characteristic of all these conditions, reflected in a pro-inflammatory state, endothelial dysfunction, and changes to innate immunity; mainly of the monocyte-macrophage system with changes in polarization, inflammation, cytotoxicity and altered antigenic presentation. In the case of SARS-CoV-2 infection, mechanisms involved in acute inflammation overlap with the patient's pro-inflammatory state, causing immune system dysfunction. SARS-CoV-2 infection amplifies already-existing alterations, causing failures in the immune system's control mechanisms. The resulting cytokine storm causes an uncontrolled systemic inflammatory response marked by high serum levels of inflammatory biomarkers and a pro-inflammatory cytokine profile with decompensation of underlying diseases. In asthma, chronic eosinophilic inflammation protects against infection by producing a reduced interferon-mediated response and a reduced number of ACE2 receptors.</p><p><strong>Conclusions: </strong>Low-grade chronic inflammation present in advanced age and chronic diseases-but not in bronchial asthma-produces a pro-inflammatory state that triggers a dysregulated immune response, favoring development of severe forms of COVID-19 and increasing lethality.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 2","pages":"42"},"PeriodicalIF":2.1,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38969323","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":"COVID-19 Wake-up Call: Equity or Else.","authors":"","doi":"10.37757/MR2020.V23.N2.15","DOIUrl":"https://doi.org/10.37757/MR2020.V23.N2.15","url":null,"abstract":"","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 2","pages":"4-5"},"PeriodicalIF":2.1,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38900846","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":"Best Wishes from a Founding Editorial Board Member.","authors":"Daniel J Ncayiyana","doi":"10.37757/MR2021.V23.N2.5","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N2.5","url":null,"abstract":"","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 2","pages":"8"},"PeriodicalIF":2.1,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38900847","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":"Clinical-Epidemiological Characteristics of the First Patients Diagnosed with COVID-19 in Cuba.","authors":"Niurka Molina-Águila,&nbsp;Elba Cruz-Rodríguez,&nbsp;Rita M Ferrán-Torres,&nbsp;Belkys M Galindo-Santana,&nbsp;Yanaris López-Almaguer,&nbsp;Manuel Romero-Placeres","doi":"10.37757/MR2021.V23.N2.3","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N2.3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;COVID-19 is caused by the novel coronavirus SARS-CoV-2 and was declared a pandemic on March 11, 2020, the same day that the first cases in Cuba were diagnosed. In Cuba, all confirmed cases of COVID-19 were hospitalized from this point forward.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Characterize the first patients diagnosed with COVID-19 in Cuba.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;METHODS We carried out a descriptive, cross-sectional study of 415 suspected cases of COVID-19 admitted to the Pedro Kourí Tropical Medicine Institute in Havana, Cuba, from March 11, 2020 through April 10, 2020. (In Cuba, all patients suspected of being COVID-19-positive were admitted to hospitals or isolation centers for observation and treatment.) Of these 415 individuals, 63 (15.2%) tested positive for SARS-CoV-2. Information was obtained from the Institute's databases as well as a standardized interview form for cases confirmed or suspected as infected with the novel coronavirus. We considered the following variables: age, sex, occupation at the time of interview, national origin, personal health history, time elapsed between symptom onset and hospital admission, signs and symptoms, diagnosis and status at discharge. We based our analysis on frequency distributions and double-entry contingency tables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age was 50 years (range: 16-94 years). The 45-54 age group represented the largest share of cases (25.4%; 16/63); persons aged ≥65 years were 20.6% (13/63); there were more men than women (55.6% vs. 44.4%). Cubans represented 52.4% (33/63) of patients while 47.6% (30/63) were from 14 countries where COVID-19 had already been identified. All foreigners and Cubans who arrived from abroad were considered imported cases (54.0%; 34/63). Health personnel (10 doctors and 1 nurse) represented 17.5% (11/63) of cases. Cough (50.8%), fever (46.0%), sore throat (22.2%) and headache (19.0%) were the most frequently reported symptoms. Asymptomatic patients represented 25.4% (16/63) of cases. Hypertension was the most frequently associated chronic disease (28.6%), followed by asthma (25.0%) and diabetes (17.9%). Patients who were admitted to hospital ≥3 days after symptom onset represented 66.7% (42/63) of cases. Mean hospital stay was 13.7 days (range: 1-27 days). Factors associated with a higher risk of contracting the disease included occupation as a healthcare worker (OR: 1.85; 95%, CI: 0.88-3.87) and aged ≥65 years (OR: 1.68; 95% CI: 0.85-3.34). Five individuals died, for a fatality rate of 7.9% (three foreigners and two Cubans; four men and one woman). Four of these patients were infected outside of Cuba and one was identified as a contact of a confirmed case. All patients who died had significant comorbidities (diabetes, asthma and hypertension). Age of deceased patients ranged from 54 to 87 years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The first patients diagnosed with COVID-19 in Cuba were admitted to the Ped","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 2","pages":"15"},"PeriodicalIF":2.1,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38969319","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":"Adverse Reactions to Antiretrovirals in Cuban Patients Living with HIV/AIDS.","authors":"Mayasil Morales-Pérez","doi":"10.37757/MR2021.V23.N2.7","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N2.7","url":null,"abstract":"<p><strong>Introduction: </strong>Disease and deaths from HIV/AIDS have decreased since antiretroviral treatment was introduced in 1996. Since 2005, as treatment availability has increased worldwide, deaths from HIV/AIDS have declined 48%. As of November 2019, 26,952 cases have been reported in Cuba, of which 5159 (19.1%) are deceased. The country has experienced a reduction in mortality rates since 2002, when antiretroviral treatment became available. Although there are clearly benefits to treatment, it is important to understand antiretroviral safety profiles as their toxicity may lower treatment adherence.</p><p><strong>Objective: </strong>Describe adverse reactions attributable to antiretrovirals used in Cuban patients living with HIV/AIDS.</p><p><strong>Methods: </strong>I studied notifications of adverse reactions to antiretrovirals used in Cuban patients with HIV/AIDS from January 2003 to December 2017. The sample consisted of 352 notifications in the National Pharmacovigilance Database regarding adverse reactions attributed to antiretrovirals. The variables considered were sex, notification year, antiretroviral drug, and number, type, frequency and severity of adverse reactions, whether or not they were preventable, and the reasons for categorizing them as they were.</p><p><strong>Results: </strong>Antiretrovirals reported an average adverse reaction rate of 2.1 per million population per year, representing 24.2% of adverse reactions produced by the antiviral drug group in that period. Adult males represented 75% (264/352) of patients who had adverse reactions to antiretrovirals. Most adverse reactions were in response to nevirapine (29.0%; 102/352) and zidovudine (26.7%; 94/352). The most frequent reactions were hypersensitivity (24.4%; 86/352), digestive disorders (15.9%; 56/352) and anemia (15.6%; 55/352). Reactions were common (62.5%; 220/352) and moderate in severity (70.4%; 248/352). Preventable reactions made up 52.6% (185/352) of adverse reactions. Of preventable reactions, 68.1% (126/185) were associated with drug interactions and 16.2% (30/185) with improper dosage or prescription errors.</p><p><strong>Conclusions: </strong>Adverse reactions to antiretrovirals in Cuban patients are common and moderate in severity. The drug with the most notifications was nevirapine, and the most common adverse reaction was hypersensitivity. More than half of adverse reactions are considered preventable, and their main causes are prescription errors.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 2","pages":"21"},"PeriodicalIF":2.1,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38969320","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":"Spatiotemporal Distribution of Non-syndromic Orofacial Clefts in Villa Clara Province, Cuba, 2013-2018.","authors":"Noel Taboada-Lugo,&nbsp;Manuela Herrera-Martínez,&nbsp;Geni Hernández-González,&nbsp;Hartley Ledesma-Hernández","doi":"10.37757/MR2021.V23.N2.8","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N2.8","url":null,"abstract":"<p><strong>Introduction: </strong>To discern environmental factors that, along with genes influencing susceptibility, drive the occurrence of non-syndromic congenital disorders, it is important to identify clusters of these abnormalities.</p><p><strong>Objective: </strong>Determine the adjusted prevalence of orofacial clefts in Villa Clara Province, Cuba, and identify and describe their spatiotemporal variability during January 2013-December 2018.</p><p><strong>Methods: </strong>Cases were selected from a total of 46,007 births that took place in the province's four maternity hospitals during the study period. Of these, 36 cases of newborns with either prenatal or postnatal non-syndromic orofacial cleft diagnoses were obtained from hospital and community registries. We applied spatial statistical analysis techniques with the aim of identifying areas within the province with the highest prevalence.</p><p><strong>Results: </strong>Adjusted prevalence was 0.78 per 1000 births. The most common non-syndromic orofacial congenital abnormality was cleft lip with or without cleft palate. Frequency of congenital abnormalities increased during the first two years of the study and decreased during the last two years. A primary spatiotemporal cluster was identified in two contiguous municipalities in 2017 and a secondary one in two other neighboring municipalities between 2014 and 2016.</p><p><strong>Conclusions: </strong>Spatiotemporal analysis of non-syndromic orofacial clefts in Villa Clara Province, Cuba, identified two spatiotemporal clusters, constituting an opportunity to better understand the etiology of orofacial clefts.</p>","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 2","pages":"27"},"PeriodicalIF":2.1,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38969321","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":"Neuropsychological & Cognitive Sequelae in COVID-19 Patients.","authors":"Yunier Broche-Pérez","doi":"10.37757/MR2021.V23.N2.14","DOIUrl":"https://doi.org/10.37757/MR2021.V23.N2.14","url":null,"abstract":"","PeriodicalId":49835,"journal":{"name":"Medicc Review","volume":"23 2","pages":"78"},"PeriodicalIF":2.1,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38969324","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}