International Journal of Psychiatry in Medicine最新文献

{"title":"Safety and efficacy of fluoxetine in post-stroke anxiety-A pilot prospective randomized open blinded endpoint (PROBE) study.","authors":"Satish Barki, Deepti Vibha, Sudhir Pachipala, Kamalesh Tayade, Shubham Misra, Manabesh Nath, Rajesh Kumar Singh, Nand Kumar","doi":"10.1177/00912174241296233","DOIUrl":"https://doi.org/10.1177/00912174241296233","url":null,"abstract":"<p><strong>Objective: </strong>The prevalence of post-stroke anxiety (PSA) is reported to be 20%-25%. There is insufficient evidence on the efficacy of antidepressants for treating anxiety in such patients. This Prospective Randomized Open Blinded Endpoint (PROBE) study was designed to assess the safety and efficacy of fluoxetine in PSA.</p><p><strong>Methods: </strong>In this single-center pilot study conducted in India, post-stroke patients (between 1 to 6 months) were randomized to fluoxetine (intervention group: 20 mg/day for 12 weeks) or standard medical care (control group). The primary outcome was improvement in the Hamilton Anxiety Rating Scale (HAM-A) at 12 weeks. The secondary outcomes were anxiety remission (>50% improvement in HAM-A), modified Rankin Scale (mRS), Barthel Index (BI), quality of life (SF-36), and Hamilton Depression Rating Scale (HAM-D). A linear regression analysis was done for determinants of HAM-A to account for baseline differences in the intervention and control groups.</p><p><strong>Results: </strong>A total of 60 patients were randomized: (30: intervention, 30: control). The overall prevalence of post-stroke anxiety among participants in the study was 50.8%, and 31.5% experienced both anxiety and depression. The average HAM-A score at baseline was 11, and average follow-up score at study conclusion was 4. There was similar improvement in the HAM-A score at 12 weeks post-randomization in the intervention and control groups [fluoxetine: -8.0 (95% CI = -11.0 to -4.0); control: -7.0 (95% CI = -9.5 to -4.0); <i>P</i> = 0.91]. Likewise, there was no significant difference between intervention and control groups at 12 weeks post-randomization on the mRS, BI, SF-36, or HAM-D. There were no serious adverse events in either group during the study.</p><p><strong>Conclusion: </strong>Fluoxetine and standard medical care had comparable improvement in HAM-A in post-stroke patients with mild anxiety at 12 weeks. Further study of the pharmacological treatment of post-stroke patients with more severe anxiety is needed.</p><p><strong>Clinical trial registration: </strong>CTRI/2018/12/016568.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512223","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":"Factors associated with caregiver burden among family members of persons with schizophrenia in urban communities of China.","authors":"Fangling Liang, Hui Du, Xin Liu, Mengyao Zheng, Changjiu He","doi":"10.1177/00912174241292702","DOIUrl":"https://doi.org/10.1177/00912174241292702","url":null,"abstract":"<p><strong>Objective: </strong>Family caregivers bear a heavy burden while providing care for those with schizophrenia, and they frequently play an important role in this regard. The present study examined the degree of caregiver burden and characteristics related to it among family caregivers of persons with schizophrenia in Chinese urban settings.</p><p><strong>Methods: </strong>Between August 2023 and June 2024, a cross-sectional study was conducted of 401 family caregivers of persons with schizophrenia living in metropolitan settings. The following measures were administered: the Zarit Burden interview (ZBI), General Self-Efficacy Scale (GSES), Social Support Rating Scale (SSRS), and Simplified Coping Style Questionnaire (SCSQ). Linear regression analyses were used to identify independent correlates of caregiver burden.</p><p><strong>Results: </strong>Family caregivers of persons with schizophrenia had an average ZBI score of 32.90(SD = 17.53) on a 0-88 scale, with the majority (80.0%) reporting moderate caregiver burden (scores of 21-39). The person with schizophrenia's marital status (not married), impulsive or aggressive conduct in the previous year, the caregiver's physical health (poor), and not having multiple caregivers were all independent correlates of caregiver burden.</p><p><strong>Conclusions: </strong>Family caregivers of persons with schizophrenia experience a moderate level of caregiver burden. To lessen the psychological suffering of and strain on caregivers, it is important to intervene early on impulsive and aggressive conduct of persons with schizophrenia, effectively treat physical health problems of caregivers, and strengthen the social support system or otherwise provide assistance to those caring for persons with schizophrenia.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479628","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":"Associations of diagnostic awareness with psychosocial symptoms and survival time in patients with advanced lung cancer.","authors":"Hulya Abali, Seda Tural Onur, Yusuf Baser, Dilara Demir, Asli Bicen","doi":"10.1177/00912174241291714","DOIUrl":"https://doi.org/10.1177/00912174241291714","url":null,"abstract":"<p><strong>Objective: </strong>Disclosing the diagnosis of lung cancer to patients is an issue, especially in the Middle East where cultural factors may prohibit disclosure from being done. The psychosocial consequences of diagnostic awareness and its impact on life expectancy of disclosure are an important issue that may influence this decision. The present study evaluated the effects of diagnostic awareness on psychosocial symptomatology and survival time in advanced lung cancer patients in Turkey.</p><p><strong>Methods: </strong>This prospective cohort study included 126 advanced lung cancer patients admitted to the oncology department between February 2021 and August 2021. A face-to-face survey included questions on age, gender, marital/employment statuses, comorbidities, and psychological symptoms (SCL-90-R). Diagnostic awareness was assessed by asking patients whether they knew their diagnosis. The correlation of diagnostic awareness with 2-year survival time was analyzed using Cox regression analysis.</p><p><strong>Results: </strong>Of the 126 patients, 86 died at the time of follow-up. Survival time and scores on SCL-90-R symptom subscales were compared between diagnosis-aware (79.4%) and diagnosis-unaware groups (20.6%). Somatization (<i>P</i> = 0.04), depression (<i>P</i> = 0.01), hostility (<i>P</i> = 0.03), scores on additional symptom scales (<i>P</i> = 0.01), and Positive Symptom Total scores (<i>P</i> = 0.01) were significantly higher in the diagnosis-unaware group. No significant difference was found between diagnostic awareness and survival time (<i>P</i> = 0.24).</p><p><strong>Conclusions: </strong>Advanced lung cancer patients aware of their diagnosis experienced less psychosocial burden. However, no significant difference was found in survival time between diagnosis-aware and diagnosis-unaware patients. These findings suggest that the diagnosis should be disclosed to lung cancer patients after confirmation of diagnosis.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479627","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 physical activity on life satisfaction among middle-aged and older adults in China: A longitudinal national study.","authors":"Yiting Kang","doi":"10.1177/00912174241291716","DOIUrl":"https://doi.org/10.1177/00912174241291716","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the impact of physical activity on life satisfaction in middle-aged and older adults in China. Utilizing longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015 and 2018, a total of 6484 participants aged 45 or older were included in the analysis.</p><p><strong>Methods: </strong>Data were collected on sociodemographic, health, and lifestyle variables, physical activity, and life satisfaction. Physical activity was categorized into 3 levels: low (71%), moderate (25%), and high (4%). Ordinal logistic regression and subgroup analysis were used to examine the effect of baseline physical activity on life satisfaction, including the examination of interaction effects.</p><p><strong>Results: </strong>After adjusting for age, gender, education, marriage, residence, smoking, alcohol use, depressive symptoms, and self-rated health at baseline (2015), compared to the moderate-intensity physical exercise group, those in the low-intensity group experienced significantly lower levels of life satisfaction on follow-up (2018). In the subgroup analyses, a significant negative effect of low-intensity physical activity on life satisfaction was found in all groups regardless of age, education, marital status, smoking, alcohol use, sleep duration, weight, presence of chronic diseases, or self-rated health.</p><p><strong>Conclusion: </strong>These results support the promotion of physical exercise to enhance life satisfaction among middle-aged and older adults in China.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394887","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":"Reduced pineal gland volume in patients with obsessive-compulsive disorder.","authors":"Murad Atmaca, Sevler Yildiz, Muhammed Fatih Tabara, Mehmet Gurkan Gurok, Mustafa Yildirim, Hanefi Yildirim","doi":"10.1177/00912174241287996","DOIUrl":"https://doi.org/10.1177/00912174241287996","url":null,"abstract":"<p><strong>Objective: </strong>Patients with obsessive-compulsive disorder (OCD) can have hyperactivity of the hypothalamic-pituitary-adrenal axis and may have increased secretion of adrenocorticotropic hormone and cortisol and reduced secretion of melatonin. Examination of pineal gland volumes in patients with OCD compared to healthy controls, thus, is an important consideration and the focus of this study.</p><p><strong>Methods: </strong>A total of 20 patients with OCD and 20 healthy controls were enrolled. Demographic and clinical characteristics of participants were assessed, and structural magnetic resonance imaging was performed.</p><p><strong>Results: </strong>Patients with OCD had a statistically significant smaller pineal gland volumes compared to healthy controls.</p><p><strong>Conclusion: </strong>In this initial small study, patients with OCD exhibited smaller pineal gland volumes compared to healthy control subjects. While this finding suggests a potential link between the pineal gland and OCD pathophysiology, further research with larger sample sizes and measurement of hormonal changes are necessary.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331576","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":"Interrelationship between depression and low back pain-related disability among patients seen at orthopedic clinics in Al Qassim region, Saudi Arabia: Prevalence, severity, and determinants.","authors":"Naif Abdullah Alsughier","doi":"10.1177/00912174241287332","DOIUrl":"https://doi.org/10.1177/00912174241287332","url":null,"abstract":"<p><strong>Objectives: </strong>Low back pain (LBP) is a widespread health problem that poses a severe economic burden on both affected patients and their societies. The purpose of this study was to investigate the association between depression and low back pain among patients seen at an orthopedic clinic and examine the association with physical disability.</p><p><strong>Methods: </strong>A cross-sectional study was carried out in the orthopedic clinics of AlBadaya General Hospital in the Qassim Region, Saudi Arabia. All patients with LBP seen in the clinic between April and June 2024 were included in the study. A questionnaire was administered that collected demographic information, asked about medical history and behaviors, and administered the Arabic-validated version of the Roland-Morris Disability Questionnaire (RMDQ) and the Patient Health Questionnaire (PHQ-9; depression). Multivariate logistic regression analysis was performed to identify correlates of depression.</p><p><strong>Results: </strong>A total of 365 patients were included in the study. Age ranged between 18 and 85 years, with a mean of 47.9 years (55.6% female). The overall prevalence of depression was 56.2%, with 40.3% being mild, 13.2% being moderate, and 2.7% being moderately severe or severe. Patients with moderately severe/severe depression had the highest disability score, while those with no depression had the lowest disability score. Multivariate logistic regression analysis revealed that with each unit increase in disability score, there was a 20% increase in depression (adjusted odds ratio = 1.20, 95% CI = 1.14-1.26, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Depression, although mostly mild, was common in this clinic sample of orthopedic patients with chronic LBP and was frequently associated with disability. Disability can be a serious complication of chronic LBP and is often closely linked with depression. As a result, patients with chronic LBP seen at orthopedic clinics in Saudi Arabia (and likely other Middle Eastern countries) should be screened for depression and managed appropriately.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299970","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":"Dietary omega-3 intake and cognitive function in older adults.","authors":"Bingdian Wang, Deqin Li, Cuicui Peng, Jingfang Hong, Yonggui Wu","doi":"10.1177/00912174241284925","DOIUrl":"https://doi.org/10.1177/00912174241284925","url":null,"abstract":"<p><strong>Objective: </strong>Dietary habits have long been known to be a critical factor influencing cognitive health, especially among older adults. Despite extensive research on various dietary components, the impact of omega-3 polyunsaturated fatty acids (PUFAs) on cognitive function has not yet been thoroughly investigated. This research seeks to determine whether more intake of omega-3 PUFAs correlates with improved cognitive function in older adults.</p><p><strong>Methods: </strong>Data were analyzed from the National Health and Nutrition Examination Survey (NHANES), which included 2430 elderly participants aged 60 and above. The association between omega-3 consumption and cognitive outcomes was evaluated using linear regression models. Smoothing curves and threshold effect analysis were employed to examine nonlinear associations. Subgroup studies were conducted to demonstrate the strength and reliability of the correlation and factors affecting them.</p><p><strong>Results: </strong>The fully adjusted model demonstrated significant positive correlations between omega-3 intake and scores on all 3 cognitive assessments performed. Specifically, in the final model, the beta coefficients for the CERAD Word Learning test, Animal Fluency Test, and Digit Symbol Substitution Test were 0.53 (95% CI: 0.33-0.72; <i>P</i> < 0.0001), 0.29 (95% CI: 0.12-0.47; <i>P</i> = 0.001), and 0.61 (95% CI: 0.19-1.03; <i>P</i> = 0.0045), respectively.</p><p><strong>Conclusion: </strong>Increased intake of omega-3 was positively and independently associated with cognitive function in older adults, suggesting that consumption of omega-3 PUFAs may help to prevent cognitive decline with aging. Prospective studies are needed to determine the direct of effect in this association.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299969","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":"Red kratom and red corvette: A case of mania induced by kratom withdrawal.","authors":"Mohammmad Abidali, Guitelle St Victor, Shady Mashaly, Pranab Dahal","doi":"10.1177/00912174241281980","DOIUrl":"https://doi.org/10.1177/00912174241281980","url":null,"abstract":"<p><p><b>Background:</b> Kratom, derived from the <i>Mitragyna speciose, a</i>  plant native to Southeast Asia, is a substance that is gaining popularity in the United States as a self-medication tool for opiate withdrawal and pain management. Its active compounds, mitragynine, and 7-hydroxymitragynine, interact with various receptors in the body, resulting in a spectrum of clinical effects.<b>Case:</b> A 56-year-old male with a history of depression and cannabis use disorder arrived at the Emergency Department in a state of severe agitation with erratic behavior and aggression. Further evaluation revealed a recent abrupt discontinuation of Kratom use. A psychiatric consultation was requested and done by our consultation-liaison team, diagnosing Kratom withdrawal as the <b>most likely</b> cause of his acute mania. Neuropsychiatric symptoms arising from Kratom toxicity is a well-documented phenomenon; however, to our knowledge, this <b>may be</b> the first documented case of acute mania induced by Kratom withdrawal.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141581","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":"Psychotropic medication and hepatobiliary health: Ultrasound observations on patients with schizophrenia.","authors":"Linlin Yue, Linlin Sun, Nan Li","doi":"10.1177/00912174241280510","DOIUrl":"https://doi.org/10.1177/00912174241280510","url":null,"abstract":"<p><strong>Objective: </strong>This study sought to examine the association between antipsychotic drug use and hepatobiliary health based on serum markers and ultrasound observations on a sample of patients with schizophrenia compared to age and gender matched healthy controls.</p><p><strong>Methods: </strong>The 120 patients with schizophrenia and 60 control subjects had their blood drawn to measure liver function tests and underwent hepatobiliary ultrasonography to determine hepatobiliary lesions. Liver function tests included total cholesterol (TC), triglycerides (TG), alanine aminotransferase (ALT), and aspartate aminotransferase (AST). Standardized cross-sectional images of the liver and kidneys were obtained from patients and controls, and analyses were stratified by length of taking psychotropic medication among those with schizophrenia. Liver echo attenuation coefficients, liver-kidney ratios, and liver fat content were determined.</p><p><strong>Results: </strong>Psychotropic drug use was associated with greater liver burden and liver lesions in patients with schizophrenia compared to controls. The levels of TC, TG, ALT and AST in patients with schizophrenia were also all significantly higher among patients with schizophrenia. Long-term psychotropic medication was associated with increased levels of fatty liver in patients compared with controls. Levels of TC, TG, ALT and AST were all significantly higher in the long-term psychotropic medication use group than in the short-term group. Liver echo attenuation coefficient, liver-kidney ratio, and liver fat content were also higher in the long-term medication use group compared to the short-term group.</p><p><strong>Conclusion: </strong>Antipsychotic drug use, particularly long-term use, is associated with increased liver burden in patients with schizophrenia, impaired lipid metabolism, increased liver lesions and fat content.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134322","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 efficacy and safety of adding celecoxib to escitalopram for improving symptoms of major depressive disorder.","authors":"Mohammad Nadi Sakhvidi, Zanireh Salami, Maryam Mosadegh, Reza Bidaki, Hossien Fallahzadeh, Razie Salehabadi, Malihe Arjmandi","doi":"10.1177/00912174231210567","DOIUrl":"10.1177/00912174231210567","url":null,"abstract":"<p><strong>Objective: </strong>There is growing evidence that adding non-steroidal anti-inflammatory drugs to some psychopharmacological treatments may help to improve symptoms in patients suffering from major depressive disorder. The present study examined the therapeutic efficacy of adding celecoxib to escitalopram and the safety of doing so.</p><p><strong>Method: </strong>In this double-blind randomized controlled trial, 60 patients with major depressive disorder were randomly assigned to either treatment with escitalopram plus celecoxib (intervention group) or escitalopram and placebo. All patients were evaluated blind to treatment group with the Hamilton Depression Rating Scale (HDRS) before the intervention as well at 4 and 8 weeks after initiating treatment. Chi-square and paired t-test were used to examine between-group differences at those assessment times.</p><p><strong>Results: </strong>There was no significant difference in depressive symptoms between intervention and placebo groups at baseline. However, at 4 and 8 weeks after the beginning of treatment, there were significant between-group differences in HDRS scores, favoring the intervention group. No between-group differences were found in treatment-related side effects.</p><p><strong>Conclusions: </strong>Adding celecoxib to escitalopram may improve symptoms of depression in patients with major depressive disorder without increasing the risk of drug-related side effects.</p>","PeriodicalId":50294,"journal":{"name":"International Journal of Psychiatry in Medicine","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812581","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}