Journal of Plastic Reconstructive and Aesthetic Surgery最新文献

{"title":"A six-year retrospective study of patient outcomes following involved or close margin basal cell carcinoma excision","authors":"Mikesh Kalpesh Patel ,&nbsp;Jaroszlav Roszpopa ,&nbsp;Animesh JK Patel","doi":"10.1016/j.bjps.2025.03.004","DOIUrl":"10.1016/j.bjps.2025.03.004","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to analyse patient management and outcomes following involved or close margin basal cell carcinoma (BCC) excision to investigate what factors influence the risk of involved and close margin excision and contribute to recurrence.</div></div><div><h3>Methods</h3><div>Histology reports identifying BCCs at Cambridge University Hospital from 2015 to 2021 were collected. After applying exclusion criteria, patient notes were analysed, looking at multiple variables in their clinical details and treatment pathway.</div></div><div><h3>Results</h3><div>A total of 160 involved margins, and 500 close-margin BCCs were included. In total, 53% of involved margin BCCs compared with 37% of close-margin BCCs showed a high-risk histological component. The rate of perineural invasion differed significantly (p &lt; 0.001) with a rate of 12.5% and 2.9% in the involved and close-margin groups, respectively. Following an involved margin excision, 36% underwent re-excision and 28% received clinic follow-up. Following a close margin excision, however, only 6.7% underwent re-excision, with 24% receiving follow-up and 65% being discharged. Three involved margins and four close-margin BCCs developed recurrence; none of these lesions received active further management following primary excision.</div></div><div><h3>Conclusions</h3><div>Despite being the most common skin cancer worldwide, it is worth discussing if the common active follow-up approach for close margin BCCs should be revised to optimise available recourses. There is evidence that patient education on self-examination and self-referral for some conditions could be as effective as monitoring by healthcare professionals. However, our observation of no recurrences in those who received further treatment suggests that further active management may improve patient outcomes.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 76-84"},"PeriodicalIF":2.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Free tissue transfer for limb salvage following acute diabetes-related foot infections: A multicentre outcome study of success and failure","authors":"Sophie C. Ghijsen ,&nbsp;Anne-Fleur Thé ,&nbsp;J. Henk Coert ,&nbsp;Erik D.H. Zonnevylle ,&nbsp;Patrick C.K.H. Khoe ,&nbsp;Olaf J. Bakker ,&nbsp;Hinne A. Rakhorst","doi":"10.1016/j.bjps.2025.03.003","DOIUrl":"10.1016/j.bjps.2025.03.003","url":null,"abstract":"<div><h3>Background</h3><div>In cases of limb-threatening diabetes-related foot infections (DFIs), the primary goal of treatment is to control the infection while maintaining as much functional limb as possible. Aggressive surgical debridement is one of the cornerstones of treatment. Once the infection is controlled, extensive soft tissue defects with exposed vital structures such as bone or joint may remain, limiting the mobility of the patient and posing a risk for the development of new (deep) infections. One possible treatment option for these soft tissue defects is free tissue transfer (FTT). Although reported FTT success rates in diabetic foot ulcers are over 90%, patient selection and indications for FTT in diabetic foot disease vary widely in the literature, and little has been described about FTT after limb-threatening DFI.</div></div><div><h3>Methods</h3><div>This multicentre, retrospective study included patients that underwent FTT after a limb-threatening DFI between 01-01-2017 and 01-03-2024 in four Dutch hospitals. The primary outcome was flap success rate within 30 days. Secondary outcomes included limb salvage within 90 days, incidence of major amputation during follow-up, ulcer recurrence, and ambulation.</div></div><div><h3>Results</h3><div>Fourteen patients with a limb-threatening DFIs were included. The flap survival rate within 30 days was 78.6% (11/14). Limb salvage within 90 days was 92.9% (13/14). The total incidence of major amputations during follow-up was 28.6% (4/14), performed after flap failure in one and ulcer recurrence in three patients.</div></div><div><h3>Conclusion</h3><div>Our results suggest that FTT following acute limb-threatening DFI is technically feasible and may increase the chance of limb salvage.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 191-197"},"PeriodicalIF":2.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of skin color difference between the breast and abdomen on breast reconstruction using free abdominal flap with visible skin paddle","authors":"Hideki Tokumoto ,&nbsp;Shinsuke Akita ,&nbsp;Mana Wada ,&nbsp;Rikiya Nakamura ,&nbsp;Shouko Hayama ,&nbsp;Kentaro Kosaka ,&nbsp;Yoshitaka Kubota","doi":"10.1016/j.bjps.2025.03.002","DOIUrl":"10.1016/j.bjps.2025.03.002","url":null,"abstract":"<div><h3>Background</h3><div>In free flaps with visible skin paddles, the skin color difference between the recipient and donor sites should be considered to improve the aesthetic outcomes. This study aimed to investigate whether the preoperative color difference, detected using colorimetric analysis, between the breast and abdomen affects the aesthetic result in unilateral breast reconstruction with free abdominal flap.</div></div><div><h3>Methods</h3><div>This study was designed as a cohort study. Average color samples of the skin paddle, ipsilateral breast, and preoperative abdomen were obtained. The group where the delta-E value between the breast and abdomen was &gt;4 preoperatively and the group where it was not compared (patients with clear difference vs. those without clear difference). Basic characteristics and delta-E values in both groups were compared preoperatively, 6 months postoperatively, and &gt;2 years postoperatively.</div></div><div><h3>Results</h3><div>The groups with and without clear differences included 102 and 46 patients, respectively. The group with clear differences had significantly high preoperative mean delta-E (6.75 ± 1.97 vs. 2.80 ± 0.76, <em>P &lt;</em> 0.001). Although delta-E was not significantly different at 6 months postoperatively, it was significantly low in the group without a clear difference (3.83 ± 1.96 vs. 2.83 ± 1.47, <em>P =</em> 0.002) at &gt;2 years postoperatively. No significant differences in other characteristics were noted. The multivariate analysis revealed that preoperative delta-E (odds rate = 1.242, <em>P</em> = 0.003) was independently a significant predictor.</div></div><div><h3>Conclusions</h3><div>In the long-term follow-up, cases without clear skin color differences preoperatively between the breast and abdomen showed good aesthetic outcomes.</div></div><div><h3>Take home message</h3><div>For breast reconstruction of a free abdominal flap with a visible skin paddle, cases without clear preoperative color differences between the breast and abdomen showed good aesthetic outcomes in &gt;2 years postoperatively when assessed using colorimetric analysis.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 48-56"},"PeriodicalIF":2.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of cervical radiation ulcer with transverse cervical artery perforator flap","authors":"Gang Li,&nbsp;Zhi Zhang,&nbsp;Jingen Sun,&nbsp;Jun Huang,&nbsp;Wang Jinlun","doi":"10.1016/j.bjps.2025.03.010","DOIUrl":"10.1016/j.bjps.2025.03.010","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"103 ","pages":"Pages 363-365"},"PeriodicalIF":2.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of acne keloidalis nuchae: A systematic review of outcomes and techniques","authors":"Chandler Hinson,&nbsp;Matthew Sink,&nbsp;Andrei Odobescu,&nbsp;Douglas M. Sammer,&nbsp;Andrew Y. Zhang","doi":"10.1016/j.bjps.2025.03.009","DOIUrl":"10.1016/j.bjps.2025.03.009","url":null,"abstract":"<div><h3>Background</h3><div>Acne keloidalis nuchae (AKN) is a chronic inflammatory condition primarily affecting the nape, characterized by keloid-like papules and nodules that may progress to scarring alopecia. While AKN disproportionately affects individuals with coarse hair, especially African Americans, its surgical management remains poorly studied. This systematic review evaluates the outcomes of surgical treatment of AKN, including recurrence rates, complications, and patient satisfaction.</div></div><div><h3>Methods</h3><div>A systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines was conducted across four databases. Studies focusing on surgical interventions for AKN were included, with data extracted on demographics, surgical techniques, complications, and outcomes.</div></div><div><h3>Results</h3><div>Sixteen studies comprising 99 patients met the inclusion criteria. AKN predominantly affected African American males (86.66%). Surgical techniques varied, with primary closure (58.16%) and secondary intention healing (28.42%) being the most common. Recurrence occurred in 19.19% of cases but was able to be managed conservatively. Hypertrophic scarring was noted in 11.43%, most commonly after primary closure. Infection rates were low (3.13%); however, topical and oral antibiotics were often part of postoperative treatment. Patient satisfaction and cosmetic outcomes were universally positive across studies, despite methodological variability.</div></div><div><h3>Conclusion</h3><div>Surgical excision is an effective treatment for AKN. While recurrence still occurs, it can be managed conservatively. Additionally, hypertrophic scarring remains a challenge for patients with AKN. Infection rates were low, and high patient satisfaction was often reported. Standardized methodologies and multicenter studies are needed to optimize surgical approaches and long-term outcomes.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 102-112"},"PeriodicalIF":2.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erosive Pustular Dermatosis: An important differential diagnosis for the non-healing burn wound","authors":"G. Hopley ,&nbsp;S. Shaharan ,&nbsp;C. Bailey ,&nbsp;D. Markeson ,&nbsp;I. Jones","doi":"10.1016/j.bjps.2025.03.008","DOIUrl":"10.1016/j.bjps.2025.03.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Erosive Pustular Dermatosis (EPD) presents a diagnostic challenge due to its non-specific biopsy findings and clinical features which overlap with other dermatological conditions but should be suspected in non-healing burns wounds. We present our experience with the condition and an investigation and treatment algorithm.</div></div><div><h3>Methods</h3><div>Three cases of EPD complicating burn wound healing are presented; two males and one female, aged 32, 40 and 56 respectively, with an average total body surface area of 33% (range 24–46%).</div></div><div><h3>Results</h3><div>The average time post-burn before EPD was suspected was 18.9 months (range 3.6–34.2 months). All three patients began treatment with potent topical steroids, following dermatological advice. Their wounds fully healed within an average of 32 days (range 27–37 days) and they remain healed after a weaning protocol.</div></div><div><h3>Conclusion</h3><div>We propose a diagnostic and therapeutic algorithm for the investigation and management of suspected EPD in the non-healing burn wound to promote early detection and treatment, thus reducing the ongoing burden of injury for burn survivors. Moving forward, it is essential for burn care providers to be aware of and maintain a high index of suspicion for EPD in patients with non-healing burn wounds, especially those resistant to conventional treatments.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 14-17"},"PeriodicalIF":2.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nationwide analysis of the association between parental age and incidence of cleft lip/palate","authors":"Bhavana Thota ,&nbsp;Augustine W. Kang ,&nbsp;Kelsi Krakauer ,&nbsp;Hoang-Viet Tran ,&nbsp;Payton Grande ,&nbsp;Jennifer Shah ,&nbsp;Rahim S. Nazerali","doi":"10.1016/j.bjps.2025.02.050","DOIUrl":"10.1016/j.bjps.2025.02.050","url":null,"abstract":"<div><h3>Introduction</h3><div>In several high-income Western countries, parenthood has increasingly been deferred to a higher age. This epidemiological study aimed to assess the relationship between maternal and paternal age and the incidence of non-syndromic cleft lip with or without the presence of a cleft palate (CLP) and cleft palate only (CP) in the United States (US).</div></div><div><h3>Methods</h3><div>We examined 22,669,736 births using a US-based cohort from 2016 to 2021. Dependent variables were non-syndromic CLP and CP. Independent variables included maternal age, race, education, and cigarette use. A separate set of modeling examined the influence of paternal factors including paternal age, race, and education. Univariate and multivariate logistic regression examined the association between variables using odds ratios and 95% confidence intervals.</div></div><div><h3>Results</h3><div>There were 11,341 non-syndromic CLP and 3645 CP cases. After adjusting for maternal race, education, pre-pregnancy smoking, and smoking during pregnancy, higher maternal (p = 0.137) and paternal (p = 0.773) age were not significantly associated with increased risk of CLP in the offspring. In adjusted models, higher maternal (p = 0.003) and higher paternal (p = 0.013) age were significantly associated with the increased risk of CP in the offspring.</div></div><div><h3>Conclusion</h3><div>Increasing maternal and paternal age is significantly associated with increased risk of CP in the offspring. The findings of this study highlight a previously unknown at-risk population with an increasing birth rate, particularly in Western countries.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"104 ","pages":"Pages 328-333"},"PeriodicalIF":2.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate lymphatic reconstruction for prevention of breast cancer related lymphoedema: Outcomes from a single UK centre","authors":"Maleeha Mughal,&nbsp;Pari-Naz Mohanna,&nbsp;Ashutosh Kothari,&nbsp;Hisham Hamed,&nbsp;Paul Roblin","doi":"10.1016/j.bjps.2023.05.031","DOIUrl":"10.1016/j.bjps.2023.05.031","url":null,"abstract":"","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"102 ","pages":"Pages 511-513"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74865228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-port and single-port tissue expanders in postmastectomy breast reconstruction: A retrospective cohort study","authors":"Sarah N. Chiang,&nbsp;Kaamya Varagur,&nbsp;Joseph G. Ribaudo,&nbsp;Gary B. Skolnick,&nbsp;Justin M. Sacks,&nbsp;Joani M. Christensen","doi":"10.1016/j.bjps.2023.09.019","DOIUrl":"10.1016/j.bjps.2023.09.019","url":null,"abstract":"<div><h3>Background</h3><div>Novel dual-port tissue expanders allow easy access to the periprosthetic space for seroma drainage and potentially reduce risk of infection or reconstruction failure. We analyzed outcomes after first-stage alloplastic breast reconstruction in patients receiving dual-port tissue expanders in comparison to those of patients receiving traditional, single-port devices.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed patients who underwent tissue expander placement from 2020 to 2021. A propensity-matched analysis was performed to compare the incidence of reconstruction failure in dual- and single-port expanders. Secondary outcomes included rates of seroma, hematoma, skin necrosis, wound dehiscence, surgical site infection, and patient-reported outcome measures.</div></div><div><h3>Results</h3><div>After propensity matching, the dual- and single-port cohorts each INCLUDED 190 breasts. There was no difference in reconstruction failure rate (17% vs. 15%, p = 0.48). Dual-port expanders had a significantly higher incidence of surgical site infections (20% vs. 12%, p = 0.04), but fewer infected dual-port expanders were explanted (58% vs. 91% of infections, p = 0.006). The remaining complication rates did not differ. Patient-reported pain interference was significantly higher in the dual-port cohort (59.1 vs. 56, p = 0.02).</div></div><div><h3>Conclusions</h3><div>Reconstruction failure rates did not differ when using single- or dual-port tissue expanders. Increased incidence of surgical site infections in dual-port expanders, possibly attributable to increased detection, and increased rate of salvage of the infected expanders were observed.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"102 ","pages":"Pages 473-479"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135347982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adipose-derived exosomes as a preventative strategy against complications in hyaluronic acid filler applications: A comprehensive in vivo analysis","authors":"Jeonghun Kim ,&nbsp;Taehee Jo ,&nbsp;Hajin Nam ,&nbsp;Byung Jun Kim ,&nbsp;Seung Min Nam ,&nbsp;Junhyung Kim ,&nbsp;Jaehoon Choi ,&nbsp;Woonhyeok Jeong","doi":"10.1016/j.bjps.2024.07.071","DOIUrl":"10.1016/j.bjps.2024.07.071","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to investigate the impact of exosomes derived from adipose-derived stem cells (ASCs) on complications arising from hyaluronic acid (HA) filler injections.</div></div><div><h3>Methods</h3><div>An HA hydrogel blended with adipose stem cell-derived exosomes was prepared and administered to the inguinal fat pads of 16 C57BL/6J mice. The control group received only HA filler (HA group), and the study group was treated with a combination of HA filler and exosomes (exoHA group). Biopsy was performed 1 week and 1, 2, 3, and 6 months after the injections. The effects were assessed using hematoxylin and eosin and Masson’s trichrome staining for histological examination, immunohistochemistry for collagen type I and Vascular Endothelial Growth Factor (VEGF), RNA sequencing, and quantitative real-time polymerase chain reaction (PCR) (<em>Il6</em>, <em>Ifng</em>, <em>Hif1a</em>, <em>Acta2</em>, <em>Col1a1</em>)<em>.</em></div></div><div><h3>Results</h3><div>RNA sequencing revealed significant downregulation of the hypoxia (false discovery rate [FDR] <em>q</em> = 0.007), inflammatory response (FDR <em>q</em> = 0.009), TNFα signaling via NFκB (FDR <em>q</em> = 0.007), and IL6 JAK-STAT signaling (FDR <em>q</em> = 0.009) gene sets in the exoHA group. Quantitative PCR demonstrated a decrease in expression of proinflammatory cytokines (<em>Il6</em>, <em>P</em> &lt; 0.05; <em>Hif1a</em>, <em>P</em> &lt; 0.05) and fibrosis markers (<em>Acta2</em>, <em>P</em> &lt; 0.05; <em>Col1a1</em>, <em>P</em> &lt; 0.05) within the exoHA group, indicating reduced inflammation and fibrosis. Compared to the exoHA group, the HA group exhibited a thicker and more irregular capsules surrounding the HA filler after 6 months.</div></div><div><h3>Conclusion</h3><div>The addition of ASC-derived exosomes to HA fillers significantly reduces inflammation and accelerates collagen capsule maturation, indicating a promising strategy to mitigate the formation of HA filler-related nodules.</div></div>","PeriodicalId":50084,"journal":{"name":"Journal of Plastic Reconstructive and Aesthetic Surgery","volume":"102 ","pages":"Pages 498-505"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}