Journal of Foot & Ankle Surgery最新文献

{"title":"Subtalar arthroereisis correction of adolescents flatfoot combined with pelvic obliquity: A retrospective study","authors":"Yuxin Yan ,&nbsp;Sumeng Chen ,&nbsp;Wen Zhou ,&nbsp;Xintao Zhang ,&nbsp;Lu Bai","doi":"10.1053/j.jfas.2025.04.005","DOIUrl":"10.1053/j.jfas.2025.04.005","url":null,"abstract":"<div><div><span><span>Adolescent flexible flatfoot can result in structural deformities such as medial arch collapse, hindfoot </span>valgus<span>, and forefoot<span> abduction, leading to fatigue and pain. Additionally, some patients develop pelvic obliquity, associated with lower back and hip discomfort. This study evaluates the clinical efficacy of subtalar arthroereisis in treating adolescent flexible flatfoot with pelvic obliquity. Thirty-two patients (mean age 11.0 ± 1.6 years) with flexible flatfoot and pelvic obliquity underwent subtalar arthroereisis. Radiological assessments of pelvic distance, pelvic tilt angle, Meary angle, Pitch angle, and ankle mortise distance were conducted preoperatively and at 3 months, 1 year, and 2 years postoperatively. Statistical analysis included the Wilcoxon rank-sum test and Spearman's correlation. Significant improvements were observed postoperatively in all measured angles and distances (</span></span></span><em>P</em> &lt; 0.001). Notable continued improvements were seen up to 2 years, particularly in pelvic distance (<em>Z</em> = -3.413, <em>P</em> &lt; 0.001) and ankle mortise distance (<em>Z</em> = -2.804, <em>P</em> = 0.003), with no recurrence. Correlations between ankle mortise distance and pelvic parameters were consistently significant across all follow-up periods. Subtalar arthroereisis is effective in treating flexible flatfoot and improves associated pelvic obliquity, with sustained benefits observed over a 2-year follow-up.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 602-607"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996234","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":"Prospective multicenter study assessing radiographic and patient outcomes following an instrumented mini-open triplanar tarsometatarsal arthrodesis with early weightbearing","authors":"Jody Peter McAleer DPM, FACFAS ,&nbsp;Amber M. Shane DPM, FACFAS ,&nbsp;Marque A. Allen DPM, FACFAS ,&nbsp;Avneesh Chhabra MD ,&nbsp;Justin Daigre MD ,&nbsp;Daniel C. Farber MD ,&nbsp;Deidre Kile MS ,&nbsp;Jeffrey E. McAlister DPM, FACFAS ,&nbsp;Abdi Raissi MD ,&nbsp;Paul Steinke DPM, FACFAS ,&nbsp;Robert P. Taylor DPM, FACFAS ,&nbsp;Robert D. Santrock MD","doi":"10.1053/j.jfas.2025.03.018","DOIUrl":"10.1053/j.jfas.2025.03.018","url":null,"abstract":"<div><div>This prospective, multicenter study assessed the radiographic, clinical, and patient-reported outcomes for hallux valgus (HV) correction performed with an instrumented 1st tarsometatarsal (TMT) system through a mini-open incision (≤4cm) with a biplanar plating construct and early return to weightbearing. One hundred and five patients were treated, with 75 and 11 patients completing their 12- and 24-month visits, respectively. The median (min, max) length of the primary dorsal incision was 3.5 cm (3.0, 4.0). Patients underwent an early weightbearing protocol with mean (95 % CI) of 7.9 (6.7, 9.1) days to weightbearing in a CAM boot. Significant improvements from baseline in mean radiographic measurements for Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), Tibial Sesamoid Position (TSP), and osseous foot width (OFW) were maintained through 12 months<strong>.</strong> Using recurrence definitions of greater than 15° and 20° postoperative HVA, recurrence rates were 5.5 % (95 % CI: 1.5 %, 13.4 %) and 0.0 % at 12 months and 0.0 % for both thresholds at 24 months, respectively. Significant improvements in patient-reported outcomes [Visual Analog Scale (VAS), Manchester-Oxford Foot Questionnaire (MOxFQ) and Patient-Reported Outcomes Measurement Information System (PROMIS)] were maintained through 12 and 24 months. A clinically meaningful assessment of the scar appearance was observed in the POSAS scores. One (1.0 %) patient in the overall treated cohort of 105 required reoperation for removal of hardware due to pain. The results of this prospective, multicenter study on a mini-open 1st TMT system demonstrated improvements in radiographic correction, low recurrence, early return to activity with low complication rates, and improvements in patient-reported outcomes.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 574-580"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744162","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":"The association of anterior soft tissue depth (ASTD) with wound dehiscence following total ankle arthroplasty","authors":"Lauren M. Christie DPM, AACFAS ,&nbsp;Avery Thomson DPM, MS ,&nbsp;Charles Korba DPM ,&nbsp;Andreas C. Kaikis DPM, FACFAS ,&nbsp;William M. Wolfe DPM, MPH ,&nbsp;D. Scot Malay DPM, MSCE, FACFAS","doi":"10.1053/j.jfas.2025.03.015","DOIUrl":"10.1053/j.jfas.2025.03.015","url":null,"abstract":"<div><div><span><span><span>Total ankle arthroplasty (TAA) is a common intervention for the treatment of end-stage ankle arthritis. Unfortunately, use of a longitudinal anterior </span>incision to gain access to the ankle is commonly associated with postoperative </span>wound dehiscence<span>. In this retrospective cohort study the incidence of postoperative anterior wound dehiscence following TAA in 100 consecutive patients was 21 %, and 7 (33.33 %) of the dehiscence cases were serious enough to require additional operative treatment. The anterior soft tissue depth (ASTD) at the level of the tibiotalar joint was measured from the anterior margin of the skin to the anterior margin of the ankle as viewed on the standard lateral radiograph. The overall median ASTD for the entire cohort was 21.79 (range 5.7 to 37.3) mm, whereas that in the non-dehiscence group was 22.06 (5.7, 37.3) mm and that in the dehiscence group was 18.6 (12.78, 35.9) mm, and this difference was statistically significant (</span></span><em>p</em> = 0.0240). Receiver operating characteristic (ROC) curve analyses showed that a preoperative ASTD ≤ 16 mm maximized diagnostic sensitivity and specificity and predicted dehiscence.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 559-565"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744163","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":"Comparison outcomes of cheilectomy, hemi-implant arthroplasty and decompression osteotomy for the treatment of hallux rigidus: A retrospective study of 153 patients","authors":"Ashley A. Mariano DPM, AACFAS ,&nbsp;Lawrence M. Fallat DPM, FACFAS","doi":"10.1053/j.jfas.2025.03.009","DOIUrl":"10.1053/j.jfas.2025.03.009","url":null,"abstract":"<div><div><span>This retrospective case series investigated the treatment outcomes for hallux rigidus<span>. A total of 153 patients (130 females, 49 males) were included. Of the 153 patients, 26 were bilateral and 179 procedures met the inclusion criteria. The patients had undergone 1 of the following procedures: cheilectomy (Group 1), hemi-implant arthroplasty<span> (Group 2), decompression metatarsal osteotomy (DMO) (Group 3), and DMO with hemi-implant (Group 4). Mean patient age was 57 years (range 18-82), and the mean follow-up period was 26 months (range 12-72). All patients regardless of procedure had improvement in pain score with Group 4 demonstrating the greatest reduction in pain at 99 %. The majority of patients in the study had Stage II hallux limitus/rigidus (HL/HR) (67 patients), followed by 62 patients with Stage III and 49 patients with Stage IV. Preoperatively, the majority of patients lacked dorsiflexion at the first </span></span></span>metatarsophalangeal joint. Group 1 gained 16° in dorsiflexion from preoperative to postoperative, Group 2 gained 20°, Group 3 gained 30° and Group 4 gained 24° by the 12 month followup. The results revealed that adhesions were the most common complication for all 4 surgical groups. These four surgical procedures for the treatment of Stage II, III and IV hallux rigidus are viable options and lead to satisfactory long-term outcomes that restore function, relieve pain and improve joint range of motion. Each procedure has demonstrated satisfactory long-term outcomes and high patient satisfaction.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 526-533"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677399","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":"Are we putting our best foot forward? The effect of insurance type on ankle fracture complications and delays in care: a retrospective two-year analysis","authors":"Nolan M. Reinhart ,&nbsp;Jackson P. Tate ,&nbsp;Chauncey A. Bridges ,&nbsp;James Clemmons ,&nbsp;Murphy P. Martin ,&nbsp;Olivia C. Lee ,&nbsp;William F. Sherman","doi":"10.1053/j.jfas.2025.04.009","DOIUrl":"10.1053/j.jfas.2025.04.009","url":null,"abstract":"<div><div><span><span>This study investigates the influence of insurance type on delays in surgical management and postoperative complications<span><span> in patients with closed operative ankle fractures. A </span>retrospective cohort study was conducted using the PearlDiver Mariner database, analyzing 37,706 ankle fracture patients who underwent </span></span>open reduction<span><span> internal fixation (ORIF). Patients were grouped by insurance type (Medicaid vs private insurance), and the time from fracture diagnosis to surgery was compared. Complications including hardware infection, revision surgery, mechanical failure, </span>nonunion, malunion, and postoperative wound issues were analyzed within two years post-surgery. A higher proportion of Medicaid patients had surgical delays beyond 10 days from initial presentation compared to privately insured patients (28.6 vs 22.2 %, </span></span><em>p</em><span> &lt; 0.001). Medicaid patients had higher rates of any orthopedic complications (odds ratio (OR): 1.27, 95 % confidence interval (CI): 1.19 - 1.37), including revision ORIF (OR: 1.33, CI: 1.16 - 1.54), mechanical failure (OR:1.24, CI: 1.03 - 1.49), nonunion or malunion (OR: 1.35, 1.17 - 1.55), and posttraumatic arthritis (OR: 1.26, 1.08 - 1.48). Although complications like wound infection and amputation were more frequent among Medicaid patients, these differences were not statistically significant. Medicaid patients experience longer delays in surgical management and higher rates of complications after ankle fractures compared to privately insured patients.</span></div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 624-628"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006216","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":"Trends in computed tomography utilization among emergency department patients with foot and ankle trauma","authors":"Soham Ghoshal BA ,&nbsp;Alexander H King MS ,&nbsp;Michael Pang BS ,&nbsp;C. Michael Hood MD ,&nbsp;Aaron D Sodickson MD, PhD ,&nbsp;Michael S Gee MD, PhD ,&nbsp;Michael H Lev MD ,&nbsp;Mitchel B Harris MD ,&nbsp;Marc D Succi MD","doi":"10.1053/j.jfas.2025.04.007","DOIUrl":"10.1053/j.jfas.2025.04.007","url":null,"abstract":"<div><div>The aim of this study was to assess the number of foot/ankle computed tomography<span> (CT) exams ordered per encounter for patients presenting to the emergency department (ED) with foot and ankle trauma over a 5-year period. Secondary aims included evaluating the positivity rate of foot/ankle CT exams and identifying factors associated with receiving a CT foot/ankle. This retrospective study analyzed data from a large urban Level-1 trauma center between 2016 and 2021. Patients were identified by charted chief complaints related to foot and ankle trauma. The primary outcome was the number of CT foot/ankle exams ordered per patient in a given period. A univariate chi-square analysis was conducted to evaluate differences in patient presentations and imaging rates across the study period.</span></div><div>Over the 5-year span, there were 9,845 patient encounters, with a significant increase in CT foot/ankle orders from 2.4 % to 6.6 % (<em>p</em> &lt; 0.001). The CT positivity rate, defined as CTs with positive findings, declined from 95.2 % in 2016 to 84.1 % in 2021 (<em>p</em> &lt; 0.001). Black patients had lower odds of receiving CT scans compared to White patients, as did Medicare recipients compared to Medicaid recipients (<em>p</em> &lt; 0.001). Factors such as age (OR: 1.02 per year), year of visit (OR: 2.66 for 2021), time of day (OR: 1.62 for evening arrivals), and arrival by EMS (OR: 5.60) were significantly associated with higher CT order rates.</div><div>This study highlights a marked increase in CT utilization for foot and ankle trauma with a corresponding decline in the rate of positive findings. Further research is necessary to explore the reasons behind this trend and to identify potential workflow or protocol adjustments to improve imaging efficacy.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 613-618"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046069","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 preoperative pes planus on orthopaedic implant removal following first metatarsophalangeal joint arthrodesis: A retrospective analysis","authors":"William B. Dyke MD ,&nbsp;Nicholas Bank MD ,&nbsp;Bradley J. Lauck BA ,&nbsp;Stephen Himmelberg MD ,&nbsp;R. Justin Mistovich MD ,&nbsp;Trapper A. Lalli MD","doi":"10.1053/j.jfas.2024.12.005","DOIUrl":"10.1053/j.jfas.2024.12.005","url":null,"abstract":"<div><div><span><span>First metatarsophalangeal (MTP) joint fusion is a frequently employed surgical treatment option for </span>hallux rigidus and </span>hallux valgus<span>. Implant-related complications are common, necessitating further investigation into predisposing factors. The altered mechanics of pes planus may influence surgical outcomes; however, its direct impact on implant removal rates post-fusion remains unclear.</span></div><div>We retrospectively analyzed the TriNetX US Collaborative Network database to identify patients undergoing first MTP joint arthrodesis by ICD-10 and CPT coding, the data was stratified by preoperative pes planus status. Implant removal rates were compared between pes planus (PP) and non-pes planus (noPP) cohorts. Odds ratios (OR) were calculated to assess associations.</div><div>Patients in the PP cohort exhibited significantly higher rates of subsequent hardware irritation (OR 1.30, 95 % CI 1.010-1.675), and hardware removal (OR 1.27, 95 % CI 1.007-1.604) compared to patients in the noPP cohort.</div><div>Our findings highlight patients with preoperative pes planus have significantly increased likelihood of implant irritation, removal, and reoperation following first MTP joint arthrodesis surgery. Biomechanical alterations associated with pes planus likely contribute to accelerated implant wear and compromise fusion stability leading to higher rates of future surgery.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 507-510"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962621","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":"Assessing the costs of midfoot arthrodesis: A retrospective cohort study","authors":"William Newton MD ,&nbsp;Andrew Rowley MD ,&nbsp;Cody Ashy MD ,&nbsp;Caroline P. Hoch MPH ,&nbsp;Joshua L. Morningstar BS ,&nbsp;Christopher E. Gross MD ,&nbsp;Daniel J. Scott MD, MBA","doi":"10.1053/j.jfas.2025.04.001","DOIUrl":"10.1053/j.jfas.2025.04.001","url":null,"abstract":"<div><div><span>This retrospective cohort study<span> aims to determine the economic cost of midfoot arthrodesis<span> when treating midfoot arthritis, identifying the major driving forces of cost. A retrospective analysis was conducted on midfoot arthrodesis cases in South Carolina from 2012 to 2020 using the South Carolina Revenue and Fiscal Affairs (SCRFA) database. Patient cases were identified by ICD-9, ICD-10, or CPT code, yielding a total of 1,313 cases included in our analysis. Patients undergoing midfoot arthrodesis were primarily female (71.1 %), Caucasian (74.6 %), insured through commercial insurance (40.2 %) or Medicare (37.3 %), and had a mean age of 54.27 years (range 4-86). The mean total cost per midfoot arthrodesis was $54,307.08 (range $9,433.05-$120,664.29) and the mean length of stay was 1.26 (range 1-6) days. Total charges trended upward from $42,857 in 2012 to $58,643.43 in 2020. Upon analysis, the largest contributors to this cost were supplies ($27,888.28), operating room costs ($15,876.80), and anesthesia costs ($3,866.70). Notably, surgeon fees were a comparatively minor contributor ($670.49). The mean total cost per midfoot arthrodesis was $54,307.08, with supplies and operating room costs exceeded 80 % of the mean total costs. With professional service (physician) fees accounting for only 1.2 % of costs, hospital systems, hospital administrators, and surgeons should consider improving their understanding of ways to reduce surgical costs, supply negotiation, and transitioning to more </span></span></span>outpatient surgery as means to improve the value of midfoot arthrodesis care.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 660-664"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992902","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":"Rejection rate, modifications, and turnaround time for patient specific instrumentation plans in total ankle replacement","authors":"Jason George DeVries DPM, FACFAS,&nbsp;Brandon M. Scharer DPM, FACFAS","doi":"10.1053/j.jfas.2025.03.007","DOIUrl":"10.1053/j.jfas.2025.03.007","url":null,"abstract":"<div><div>Patient specific instrumentation (PSI) in total ankle replacement (TAR) has been reported to be accurate and time saving. However, there has been criticism regarding accuracy and an overreliance on the preoperative plan. This is a retrospective review of a single surgeon's PSI plans from 2016-2024. We report rejection rates, modifications, and turnaround time. A total of 101 plans were reviewed and found an overall rejection rate of 17.8 %, with 18 reports rejected. Average turnaround time was 29:07 hours. When comparing the 1st half of the study period to the second half, a statistically significant increase in rejection rate was found, 0 % to 45 %, p &lt; 0.0001. In addition, there was a higher rate of rejection on more complicated stemmed implants or revision implants compared to low profile implants. This report shows there is not a blind trust of the engineer's plan, and with experience with PSI rejection rate increases. Also, the engineer's understanding of complicated cases is addressed with higher rates of rejection in complicated cases. This report refutes charges that surgeons that use PSI for TAR are overly reliant on CT-derived engineer produced plans. Further studies with national data or multiple surgeons should be undertaken to explore this further.</div></div>","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Pages 516-520"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587786","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":"Subscription Information","authors":"","doi":"10.1053/S1067-2516(25)00216-9","DOIUrl":"10.1053/S1067-2516(25)00216-9","url":null,"abstract":"","PeriodicalId":50191,"journal":{"name":"Journal of Foot & Ankle Surgery","volume":"64 5","pages":"Page A2"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145005272","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}