Journal of Clinical Sleep Medicine最新文献

{"title":"Progress in alternative diagnostic modalities for pediatric obstructive sleep apnea: a global need.","authors":"Nataly Sanchez-Solano, Christopher M Cielo","doi":"10.5664/jcsm.11464","DOIUrl":"10.5664/jcsm.11464","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"7-8"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559279","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":"Clinical characteristics and phenoconversion in isolated REM sleep behavior disorder: a prospective single-center study in Korea, compared with Montreal cohort.","authors":"Jung-Ick Byun, Jun-Sang Sunwoo, Yong Woo Shin, Jung-Won Shin, Tae-Joon Kim, Jin-Sun Jun, Jung Hwan Shin, Han-Joon Kim, Jacques Montplaisir, Jean-François Gagnon, Amelie Pelletier, Aline Delva, Ronald B Postuma, Ki-Young Jung","doi":"10.5664/jcsm.11318","DOIUrl":"10.5664/jcsm.11318","url":null,"abstract":"<p><strong>Study objectives: </strong>Isolated rapid eye movement sleep behavior disorder is a prodromal synucleinopathy, but its conversion rate and subtypes can vary among different cohorts. We report the clinical characteristics and phenoconversion rate of the large single-center isolated rapid eye movement sleep behavior disorder cohort in Korea and compared it to the Montreal cohort.</p><p><strong>Methods: </strong>This prospective cohort study examined 238 patients with polysomnography confirmed isolated rapid eye movement sleep behavior disorder from Seoul National University Hospital (SNUH) who completed at least 1 follow-up evaluation. We compared the baseline and phenoconversion data of the SNUH cohort to those of 242 isolated rapid eye movement sleep behavior disorder patients in the Montreal cohort.</p><p><strong>Results: </strong>In the SNUH cohort, age at rapid eye movement sleep behavior disorder diagnosis was similar (66.4 ± 7.8 vs 65.6 ± 8.4, <i>P</i> = .265), but the proportion of men was lower (63.0% vs 74.0%, <i>P</i> = .01), and the duration of follow-up was shorter than that in the Montreal cohort (3.7 ± 2.0 vs 4.8 ± 3.6 years, <i>P</i> < .001). During follow-up, 34 (11.8%) patients in the SNUH cohort converted to neurodegenerative disease: 18 (52.9%) to Parkinson's disease, 9 (26.5%) to dementia with Lewy bodies, and 7 (20.6%) to multiple system atrophy. The conversion rate in the SNUH cohort was 15% after 3 years, 22% after 5 years, and 32% after 7 years, which was significantly lower than that of the Montreal cohort (log-rank test, <i>P</i> = .002). Among phenoconversion subtype, fewer patients in the SNUH group than in the Montreal group converted to dementia with Lewy bodies (Gray's test <i>P</i> = .001).</p><p><strong>Conclusions: </strong>Through a comparative analysis between the SNUH and Montreal cohorts, we identified a significant difference in phenoconversion rates, particularly for dementia with Lewy bodies patients. These findings underscore the importance of further research into the underlying factors, such as racial and geographical factors contributing to such disparities.</p><p><strong>Citation: </strong>Byun J-I, Sunwoo J-S, Shin YW, et al. Clinical characteristics and phenoconversion in isolated REM sleep behavior disorder: a prospective single-center study in Korea, compared with Montreal cohort. <i>J Clin Sleep Med</i>. 2025;21(1):81-88.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"81-88"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037627","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":"Allergic reaction to hypoglossal nerve stimulator: a case report.","authors":"Katherine P Gouldman, Jason L Yu","doi":"10.5664/jcsm.11370","DOIUrl":"10.5664/jcsm.11370","url":null,"abstract":"<p><p>Little is documented about the frequency and management of allergic reactions to hypoglossal nerve stimulator implants. This case report describes a 69-year-old female with obstructive sleep apnea who received a hypoglossal nerve stimulator device and had an adverse reaction concerning for an allergic reaction to the medical device. The complication was managed via topical steroids, and although the patient's symptoms initially resolved she experiences continued intermittent maculopapular pruritic rashes approximately once per week. This case report details the patient's presentation, including progression and management, while also highlighting the diagnostic challenges in identifying allergic reactions to medical implants and offering considerations for future management.</p><p><strong>Citation: </strong>Gouldman KP, Yu JL. Allergic reaction to hypoglossal nerve stimulator: a case report. <i>J Clin Sleep Med.</i> 2025;21(1):211-213.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"211-213"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299868","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":"Effect of graduated drug therapy for moderate-to-severe chronic insomnia on the severity of disease: an observational study in Germany.","authors":"Jolijn Boer, Theresa Toncar, Arne Stange, Lisa Rosenblum, Ingo Fietze","doi":"10.5664/jcsm.11334","DOIUrl":"10.5664/jcsm.11334","url":null,"abstract":"<p><strong>Study objectives: </strong>Severe chronic insomnia is a common sleep disorder that is mostly persistent and needs to be treated. Pharmacologic treatment options and guidelines are sparse, particularly for long-term treatment. Our study aimed to investigate a graduated therapy scheme for moderate-to-severe chronic insomnia in practice, considering the effects on self-reported sleep quality and quality of life.</p><p><strong>Methods: </strong>Patients with moderate-to-severe chronic insomnia were given appropriate medication according to a graduated therapy scheme, ranging from l-tryptophan (as the first choice, least potent) to Z-drugs and combination therapies (as the last option, most potent). Each step of the graduated therapy scheme was tested for at least 4 weeks. Data related to sleep and quality of life were collected in questionnaire form (Insomnia Severity Index, Pittsburgh Sleep Quality Index, Beck Depression Inventory, second edition, and Short Form 36 Health Survey) at baseline and during the course of the treatment after 1, 3, 6, 9, and 12 months.</p><p><strong>Results: </strong>Of 86 eligible patients, 60.5% started treatment with l-tryptophan and 8.1% with melatonin. After 3 months, 12.5% were still taking l-tryptophan and 12.5% were taking melatonin. There was a significant decrease in mean Insomnia Severity Index, Pittsburgh Sleep Quality Index, Beck Depression Inventory, second edition, and Short Form 36 Health Survey scores after 3 months of treatment for all patients in the study (n = 64). After 6 months, 22.2% were still taking l-tryptophan, melatonin, or agomelatine, and the remainder had switched to more potent drugs such as antidepressants, hypnotics, daridorexant, or combination therapies.</p><p><strong>Conclusions: </strong>A significant number of patients already responded favorably to mild sleep medications, whereas others demonstrated a need for more potent treatments. Ongoing monitoring will evaluate the long-term effectiveness of both approaches.</p><p><strong>Clinical trial registration: </strong>Registry: German Clinical Trials Register; Name: Schlafqualität und Lebensqualität mit einer medikamentösen Langzeittherapie bei moderater bis schwerer Insomnie; URL: https://drks.de/search/de/trial/DRKS00033175; Identifier: DRKS00033175.</p><p><strong>Citation: </strong>Boer J, Toncar T, Stange A, Rosenblum L, Fietze I. Effect of graduated drug therapy for moderate-to-severe chronic insomnia on the severity of disease: an observational study in Germany. <i>J Clin Sleep Med.</i> 2025;21(1):33-45.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"33-45"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019407","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":"How we measure hypoglossal nerve stimulator outcome matters: titration vs single amplitude efficacy sleep studies.","authors":"Thomas M Kaffenberger, Elliott M Sina, Bryce Hambach, Praneet Kaki, Antony Fuleihan, Maurits Boon, Colin Huntley","doi":"10.5664/jcsm.11328","DOIUrl":"10.5664/jcsm.11328","url":null,"abstract":"<p><strong>Study objectives: </strong>Hypoglossal nerve stimulator (HGNS) is a common treatment for obstructive sleep apnea. Objective assessment of HGNS efficacy measures apnea-hypopnea index (AHI) by multiamplitude titration polysomnography (tPSG) and/or a single amplitude, full-night type 3 home sleep study (eHST). Both tests have been used to determine efficacy despite significantly different protocols. This project's aim was to determine differences in objective outcomes in HGNS patients who underwent both tPSG and eHST postoperatively.</p><p><strong>Methods: </strong>Data from 379 consecutive HGNS patients were retrospectively reviewed. Inclusion requirements were a preoperative sleep study, a postoperative tPSG, and then an eHST, which at our institution is a type 3 home study. AHI mean and differences were calculated. Wilcoxon rank sum tests were used to analyze differences between tPSG and eHST. Sher₁₅ criteria (postoperative AHI ≤ 15 events/h and ≥ 50% reduction from baseline) were calculated and compared by χ² tests.</p><p><strong>Results: </strong>Ultimately 61 patients met inclusion criteria with an average preoperative AHI = 33.2 events/h. When comparing the patient's tPSG vs eHST, tPSG AHI was significantly lower (AHI = 8.8 events/h vs AHI = 17.6 events/h; respectively, <i>P</i> < .001). There was also a difference in the percentage of patients that met Sher₁₅ criteria when using tPSG (80.3%) vs eHST AHI (45.9%).</p><p><strong>Conclusions: </strong>HGNS patient's postoperative tPSG AHI was significantly lower than their eHST outcome. This work highlights the importance of reporting the type of postoperative study used in evaluating HGNS efficacy and the need for single amplitude, full-night studies to assess HGNS efficacy more accurately.</p><p><strong>Citation: </strong>Kaffenberger TM, Sina EM, Hambach B, et al. How we measure hypoglossal nerve stimulator outcome matters: titration vs single amplitude efficacy sleep studies. <i>J Clin Sleep Med</i>. 2025;21(1):47-53.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"47-53"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019409","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":"Bedtime procrastination and sleep disturbances: a call for targeted research and interventions to improve sleep health.","authors":"Vanessa M Hill, Hailey Meaklim, Sally A Ferguson, Moira Junge, Amanda L Rebar, Grace E Vincent","doi":"10.5664/jcsm.11364","DOIUrl":"10.5664/jcsm.11364","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"219-220"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299870","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":"Utility of overnight oximetry indices in the evaluation of children with snoring and suspected obstructive sleep apnea.","authors":"Yu Qian Koh, Rehena Sultana, Arun Pugalenthi, Yi Hua Tan, Ooh Hoe Teoh, Zai Ru Cheng, Duo-Tong Cheng, Oh Moh Chay, John Carson Allen, Soh Gin Tan, M Lim, Jasmine Tan, Biju Thomas","doi":"10.5664/jcsm.11344","DOIUrl":"10.5664/jcsm.11344","url":null,"abstract":"<p><strong>Study objectives: </strong>Optimal cutoff values of oximetry indices that differentiate obstructive sleep apnea (OSA) from primary snoring (PS) are not well-established. Our study aimed to assess the utility of overnight oximetry indices in differentiating PS from OSA and assessing OSA severity, compared to polysomnography, in children with suspected OSA.</p><p><strong>Methods: </strong>This was a retrospective study of children (1-18 years of age) with snoring who underwent polysomnography. Patients with Down syndrome, craniofacial anomalies, known genetic syndromes, neuromuscular conditions, or a central apnea index ≥ 5 were excluded. Demographic data, polysomnography variables, and oximetry indices (eg, oxygen desaturation index [ODI₃, defined as number of ≥ 3% desaturation episodes/h of artifact-free recording time, and SpO₂ nadir]) were collected.</p><p><strong>Results: </strong>Of 1,203 children (mean age 9.1 ± 3.9 years, 67.7% males), 91.8% (847/923) ≤ 12 years and 84.3% (236/280) > 12 years of age had OSA. The optimal cutoff of ODI₃ for differentiating PS from OSA was 2.4 (sensitivity [Se]: 78.8% [75.9-81.6%]; specificity [Sp]: 80.5% [69.9-88.7%]) in children ≤ 12 years of age and 3.6 (Se: 71.1% [64.8-76.8%]; Sp: 91.1% [78.8-97.5%]) in children > 12 years of age. The optimal cutoffs of ODI₃ for differentiating PS from mild, moderate, and severe OSA categories were 2.0 (Se: 70.1% [65.3-74.5%]; Sp: 70.1% [58.6-80.0%]), 3.7 (Se: 82.3% [76.6-87.1%]; Sp: 94.8% [87.2-98.6%]), and 4.3 (Se: 99.1% [96.8-99.9%]; Sp: 98.7% [93.0-100.0%]) in children ≤ 12 years of age and 1.9 (Se: 78.8% [75.9-81.6%]; Sp: 80.5% [69.9-88.7%]), 4.1 (Se: 85.4% [72.2-93.9%]; Sp: 91.1% [78.8-97.5%]), and 6.9 (Se: 98.4% [91.2-100.0%]; Sp: 97.8% [88.2-99.9%]) in children > 12 years of age, respectively.</p><p><strong>Conclusions: </strong>This study provides optimal cutoff values for ODI₃ in differentiating PS from OSA and assessing OSA severity in children. Because oximetry is cheaper and widely available, ODI₃ has the potential to be incorporated into cost-effective clinical decision-making algorithms, especially in resource-limited settings.</p><p><strong>Citation: </strong>Koh YQ, Sultana R, Pugalenthi A, et al. Utility of overnight oximetry indices in the evaluation of children with snoring and suspected obstructive sleep apnea. <i>J Clin Sleep Med.</i> 2025;21(1):109-121.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"109-121"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299876","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":"Dreams interrupted: characteristics of REM sleep-associated seizures and status epilepticus.","authors":"Graham A McLeod, Paul A Szelemej, Darion Toutant, Marna B McKenzie, Marcus C Ng","doi":"10.5664/jcsm.11336","DOIUrl":"10.5664/jcsm.11336","url":null,"abstract":"<p><strong>Study objectives: </strong>Seizures are rare in rapid eye movement (REM) sleep. However, seizures sometimes occur in REM sleep, and a small number of focal epilepsy patients display their maximum rate of interictal epileptiform discharges in REM sleep. We sought to systematically identify and characterize seizures in REM sleep.</p><p><strong>Methods: </strong>We reviewed all admissions to the epilepsy monitoring unit at the Winnipeg Health Sciences Center over 12 months in 2014-2015. American Academy of Sleep Medicine sleep-stage scoring was initially applied in the standard 30-second epochs. Then, to capture sudden changes in sleep-wake state on shorter timescales that are associated with seizure formation and propagation, we rescored ictal and peri-ictal electroencephalography epochs every 1 second. Patients found to have seizures in REM sleep were subject to chart review spanning 3 years pre- and postadmission.</p><p><strong>Results: </strong>REM sleep seizures occurred in 3 of 63 patients admitted to the epilepsy monitoring unit. Notably, 1 patient exhibited continuous epileptiform activity, consistent with focal nonconvulsive electrographic status epilepticus, throughout REM sleep cycles for each night of her admission. Otherwise, discrete REM sleep seizures constituted a small fraction of the other patients' total seizures (range 5.0-8.3%), occurred shortly after REM sleep onset from stage N2 sleep, and were manifest as minor epileptic arousals.</p><p><strong>Conclusions: </strong>Our results confirm that REM sleep seizures are rare, while highlighting outliers who widen the known spectrum of heterogeneous sleep effects on seizures/epilepsy. We also report, to our knowledge, the first case of paradoxical status epilepticus in REM sleep.</p><p><strong>Citation: </strong>McLeod GA, Szelemej PA, Toutant D, McKenzie MB, Ng MC. Dreams interrupted: characteristics of REM sleep-associated seizures and status epilepticus. <i>J Clin Sleep Med.</i> 2025;21(1):23-32.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"23-32"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019406","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":"Sleep-disordered breathing and diabetes mellitus: a deadly duo.","authors":"Eden Engal, Liya Kerem, Alex Gileles-Hillel","doi":"10.5664/jcsm.11462","DOIUrl":"10.5664/jcsm.11462","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"3-5"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559282","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":"CPAP complications after dacryocystorhinostomy: a narrative review.","authors":"Arpan Sahoo, Emily Kreibich, Mark Tabor, Abhay Sharma","doi":"10.5664/jcsm.11314","DOIUrl":"10.5664/jcsm.11314","url":null,"abstract":"<p><strong>Study objectives: </strong>Patients with obstructive sleep apnea often require the use of a continuous positive airway pressure (CPAP) machine. However, some patients experience issues using CPAP after receiving a dacryocystorhinostomy (DCR) for epiphora. This review aims to assess these complications and the potential interventions.</p><p><strong>Methods: </strong>A systematic literature search was conducted in March 2023 with the PubMed, EMBASE, Web of Science, and Scopus databases. Since most of the studies were case reports and lacked quantitative results, a narrative review was done.</p><p><strong>Results: </strong>Fourteen studies were included for review, representing 49 patients. During nightly CPAP use, 77.6% (38/49) of patients experienced air regurgitation onto the ocular surface via the tear drainage passage constructed by DCR. The interventions attempted could be categorized into (1) CPAP changes or (2) ophthalmic management. CPAP changes included changing the CPAP mask (successful in 5/6 patients), modifying the pressure or incorporating heated humidifier tubing (2/8 successes), changing the ventilation mode (1/3 successes), and switching to a CPAP alternative (1/2 successes). Ophthalmic management included eye plugs (3/3 successes), eye lubricants (2/6 successes), an eye patch (1/2 successes), and removal of the Lester Jones tube placed during DCR (1/1 successes). After trying these interventions, 36.7% (18/49) of patients continued to experience symptoms and opted to discontinue CPAP therapy.</p><p><strong>Conclusions: </strong>CPAP-related issues after DCR are common and can be difficult to treat. There are a variety of techniques to improve CPAP use and adherence after DCR.</p><p><strong>Citation: </strong>Sahoo A, Kreibich E, Tabor M, Sharma A. CPAP complications after dacryocystorhinostomy: a narrative review. <i>J Clin Sleep Med</i>. 2025;21(1):201-206.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":" ","pages":"201-206"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299872","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}