Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique最新文献

{"title":"Psychological first aid in operation for military healthcare providers : a study on pre-deployment training","authors":"Frédérique Gignoux-Froment ,&nbsp;Emeric Saguin ,&nbsp;Cécile Gorin ,&nbsp;Marianne Daudin ,&nbsp;Sophie Annette ,&nbsp;Julia Salomé ,&nbsp;Mathieu Boutonnet ,&nbsp;Luc Aigle ,&nbsp;Pierre-Éric Schwartzbrod ,&nbsp;Stéphane Travers ,&nbsp;Bertrand Lahutte ,&nbsp;Marie-Dominique Colas","doi":"10.1016/j.encep.2024.05.005","DOIUrl":"10.1016/j.encep.2024.05.005","url":null,"abstract":"<div><h3>Introduction</h3><div>During operational missions, while the management of physical injuries in the field remains the priority, the identification of operational incapacity of psychological origin is necessary as it is equally crucial for the safety of the individual, the group and the mission. The French Military Health Service has developed a Psychological First Aid Training in Operation (PFATO) course based on relational simulations, for military service members. The aim is to identify the early signs of psychological distress in a comrade and to adopt an adapted and protective attitude. PFATO training is also offered to healthcare providers.</div></div><div><h3>Methods</h3><div>We conducted a descriptive cross-sectional study using a self-administered online questionnaire which was sent after deployment to all physicians or nurses trained in PFATO between July 2019 and July 2021 (<em>n</em> <!-->=<!--> <!-->80). The main objective of our work was to evaluate the relevance of this awareness training among physicians and nurses and to identify specific complementary expectations in operational psychiatry for this population.</div></div><div><h3>Results</h3><div>We obtained a response rate of 55%. Significantly, 21.62% of participants used PFATO during their last deployment and another 20% observed a team member using PFATO. The circumstances of use as reported by participants included acute stress related to combat, conflict with hierarchy or comrades, and suicidal crisis. Among those who used PFATO, the training helped 87.5% of them to identify signs of psychological distress and 100% of them to assist combatants . All respondents stressed the added value of practical simulations during PFATO education. Moreover, this study also makes it possible to identify adaptations needed to optimize this module for healthcare providers.</div></div><div><h3>Conclusion</h3><div>The results suggest the value for healthcare provider of training in first-response psychological care using relational simulation based on the model of raising awareness about PFATO.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 285-292"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146777","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":"Suicide attempts in Martinique and Reunion Island and appointments no-show","authors":"Comsar Ndiaye ,&nbsp;Antone Messiah ,&nbsp;Erick Gokalsing ,&nbsp;Nelly Lislet ,&nbsp;Claire Gillet ,&nbsp;Eric Rene ,&nbsp;Noor Atwan ,&nbsp;Louis Jehel ,&nbsp;Michel Spodenkiewicz","doi":"10.1016/j.encep.2024.03.007","DOIUrl":"10.1016/j.encep.2024.03.007","url":null,"abstract":"<div><h3>Objectives</h3><div>Studies on suicidal behaviors in the French overseas territories remain rare. Although mental health resources are limited, some patients identified as being at risk of suicide do not attend the specialist consultations scheduled after identification or screening. Thus, the objective of our study was, firstly to provide a descriptive profile of patients followed up for a suicide attempt in Martinique and Reunion Island, and secondly to explore the risk factors associated with appointments no-show during follow-up.</div></div><div><h3>Methods</h3><div>We conducted an ancillary retrospective cross-sectional study using data from the APSOM study. Data were collected on 255 patients aged at least 16, admitted to hospital emergency departments after a suicide attempt and followed up in ambulatory care, including 137 in Martinique and 118 in Reunion Island. The characteristics of the sample were described by means [min, max] and proportions [95% confidence intervals]. Differences according to the presence of appointments no-show or not were analyzed using comparison tests of means and percentages (Chi², Fisher and Wilcoxon). Factors associated with appointments no-show were analyzed using a bootstrapped multivariate logistic regression model.</div></div><div><h3>Results</h3><div>The mean age of patients was 35 years [16–84 years]. Women were predominant with a sex ratio of 2.4:1 (71% women). Unemployment affected 37% [28%, 46%] of patients in Martinique and 49% [40%, 59%] in Reunion Island. Psychoactive substances consumption at the time of the suicidal act was observed in 36% [27%, 45%] of patients in Martinique and 34% [26%, 44%] in Reunion Island. The average number of suicide attempts was two per patient [1–20]. Finally, we found no significant association with appointments no-show except for center. Patients from Reunion Island were associated with better compliance than patients from Martinique (OR: 0.20 [0.05–0.65], <em>P</em> <!-->&lt;<!--> <!-->0.012).</div></div><div><h3>Conclusion</h3><div>Our study provides a description of suicide attempts admitted to hospital and followed up in ambulatory care in two French overseas territories and suggests interesting approaches for adapting prevention strategies to the socioeconomic context and cultural realities of these territories, particularly outreach interventions for the most vulnerable patients.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 240-248"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607217","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":"Stigma: Bipolar disorder versus cancer, a first-person account","authors":"Marie Milandelle ,&nbsp;Francis Gheysen ,&nbsp;Hélène Verdoux","doi":"10.1016/j.encep.2024.08.002","DOIUrl":"10.1016/j.encep.2024.08.002","url":null,"abstract":"<div><div>The author shares her experience as patient and epidemiologist with bipolar disorder and cancer. She explains why stigma was more challenging to bear with bipolar disorder than with cancer. This account also includes the perspective of two psychiatrists who provided her medical care. This paper aims to share a message of hope with patients with psychiatric diseases and offer some thoughts to help to reduce a patient's stigma.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 338-340"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607216","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":"Neuroimaging correlates of cognitive disorders secondary to electroconvulsive therapy: A systematic review","authors":"Johann Hassan ,&nbsp;Patrice Péran ,&nbsp;Antoine Yrondi","doi":"10.1016/j.encep.2024.08.004","DOIUrl":"10.1016/j.encep.2024.08.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Electroconvulsive therapy is known as an efficient therapy, which is sometimes recommended for the management of severe and resistant depression. However, ECT is associated with cognitive adverse effects. The study of the neurobiological correlates of the cognitive adverse effects of ECT has been covered in few published reviews. However, these mechanisms have been investigated in an increasing number of studies in recent years, particularly in neuroimaging. This systematic review of the literature focuses on correlates between changes in structural or functional neuroimaging and impairment of cognitive functions during the ECT treatment.</div></div><div><h3>Methods</h3><div>We conducted a systematic review of the literature using PRISMA methodology. Searches were performed on the Medline and Web of Science databases using the following equation: “electroconvulsive therapy AND (MRI OR fMRI OR DTI OR neuroimaging) AND depression AND cogniti*”.</div></div><div><h3>Results</h3><div>This article highlights the significant heterogeneity of the results. In structural imaging, approximately 50% of the studies did not report any correlation between volumetric changes and neuropsychological changes. In studies that did highlight a correlation, the latter was mainly reported with changes in the hippocampus. From a functional perspective, we highlighted a correlation between changes in the connectivity of the hippocampal region and cognition.</div></div><div><h3>Conclusion</h3><div>These results demonstrate a growing interest in understanding the neurobiological mechanisms underlying cognitive disorders secondary to ECT treatment. The ultimate aim behind this understanding is to adopt a more effective prevention strategy vis-à-vis these adverse effects.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 308-317"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607196","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":"Retrospective study of hepatitis C screening and seroprevalence in the GHU Paris","authors":"Alexandra Pham-Scottez ,&nbsp;Valérie Dauriac-Le Masson ,&nbsp;Oumeyma Ben Dahman ,&nbsp;Armel Toquin ,&nbsp;Amine Benmostefa ,&nbsp;Nabil Hallouche","doi":"10.1016/j.encep.2024.05.002","DOIUrl":"10.1016/j.encep.2024.05.002","url":null,"abstract":"<div><h3>Objectives</h3><div>The prevalence of hepatitis C virus (HCV) has been estimated to be approximately ten times higher in patients with psychiatric disorders, but European data are rare and only two French studies have recently been published on the subject. Our objective was to determine the HCV screening rate and the prevalence of HCV in adult patients hospitalised in the largest French psychiatric hospital.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of all adult patients hospitalised at GHU Paris, from 2019 to 2022, including age, gender, HCV screening, HCV serological status, and the existence of an ICD-10 diagnosis of psychoactive substance use disorder. Descriptive statistics used means<!--> <!-->±<!--> <!-->standard deviations and percentages. Bivariable comparisons used Student's <em>t</em> test and Chi-square test.</div></div><div><h3>Results</h3><div>The overall HCV screening rate was 55.4% and increased over the four years from 37.1% in 2019 to 69.4% in 2022. Patients screened were significantly younger people and with a substance use disorder than unscreened patients. The prevalence of HCV over this 4-year period was 2.8% and remained stable. The HCV-positive patients were significantly more male, older and more likely to have substance use disorders than the HCV-negative patients.</div></div><div><h3>Conclusions</h3><div>We found a prevalence rate of HCV ten times higher than the prevalence in the general population, in line with findings in many other European countries. The eradication of HCV will not be possible without the elimination of this “forgotten reservoir” of the virus. Efforts must be made in psychiatric hospitals to test all patients in order to treat patients suffering from hepatitis C with direct-acting antivirals.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 280-284"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146778","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":"Validation of the French version of the preschool form of the social responsiveness scale-second edition (SRS-2-P)","authors":"Marie-Christine Picot ,&nbsp;Cécile Michelon ,&nbsp;Julie Loubersac ,&nbsp;Amaria Baghdadli","doi":"10.1016/j.encep.2024.05.008","DOIUrl":"10.1016/j.encep.2024.05.008","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the psychometric properties of the French form of the preschool social responsiveness scale-2 (SRS-2-P-Fr).</div></div><div><h3>Participants</h3><div>A sample of French children aged 2 to 4 years comprising a group of 93 children with autism spectrum disorder (ASD) and a community control group of 201 children.</div></div><div><h3>Materials and methods</h3><div>Study of internal consistency using Cronbach's α coefficient, convergent validity using correlations with the ADI-R and ADOS-2, and diagnostic accuracy using the receiver operating characteristic curve to determine the best threshold scores useful for screening ASD in preschool children.</div></div><div><h3>Results</h3><div>Good internal consistency (0.78 to 0.98) according to Cronbach's alpha coefficients for the total score and the sub-scores of the SRS-2-P scale. The study of convergent validity showed strong correlations with the total score of the ADOS-2 Toddlers and the communication and reciprocal social interaction sub-scores of the ADI-R. Diagnostic accuracy indicated that the best cut-off score for detecting ASDs was 56 (area under the curve<!--> <!-->=<!--> <!-->0.97, sensitivity 0.925, specificity 0.98).</div></div><div><h3>Conclusion</h3><div>The SRS-2-P-Fr is a valid instrument for the early detection of ASD in preschool children in France and can facilitate diagnosis.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 300-307"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378590","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":"French version of the Parental Emotion Regulation Inventory (PERI 2)","authors":"Sidonie Hussenot-Desenonges,&nbsp;Jaqueline Wendland","doi":"10.1016/j.encep.2024.03.006","DOIUrl":"10.1016/j.encep.2024.03.006","url":null,"abstract":"<div><div>The Parental Emotion Regulation Inventory 2 (PERI 2) is designed to assess parents’ emotion regulation during discipline interactions with their children. The objective of this study was to examine the psychometric properties of a French translation and adaptation of the PERI 2. Two hundred and forty-six parents of children aged 1 to 3 years old participated in this study. The participants were recruited both face-to-face in a childcare centre and remotely through social networks. They were asked to fill out various questionnaires including the PERI 2 on an online platform. The adequacy indices of the confirmatory analysis were satisfying and validated a 4-factor model. The internal consistency of the overall scale and the subscales was satisfying. The convergent validity of the cognitive reappraisal and expressive suppression factors showed a strong association with the global reappraisal and suppression constructs. The escape factor was positively associated with constructs measuring negative experienced emotion during discipline encounters and physical aggression in children but negatively associated with measures of over reactivity. The capitulation factor was positively associated with constructs measuring negative experienced emotion during discipline encounters, child physical aggression, and global expressive suppression. The association with the laxity factor was negative. The French version of the PERI 2 is a reliable tool to measure cognitive reappraisal and expressive suppression in parents. The tool can be used in research with parents of young children in the context of disciplinary interactions. A short version could also be created for clinical use in order to assess difficulties in the emotion regulation of parents of young children and to assess treatment efficacy.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 233-239"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900165","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":"A replication study of sHLA-E influence on schizophrenia and bipolar disorder","authors":"Ons Mihoub ,&nbsp;Arij Ben Chaaben ,&nbsp;Wahid Boukouaci ,&nbsp;Mohamed Lajnef ,&nbsp;Ching-Lien Wu ,&nbsp;Jihène Bouassida ,&nbsp;Kaori Saitoh ,&nbsp;Sobika Sugunasabesan ,&nbsp;Soumia Naamoune ,&nbsp;Jean-Romain Richard ,&nbsp;Hamdi El Kefi ,&nbsp;Hanen Ben Ammar ,&nbsp;Zouhair El Hechmi ,&nbsp;Fathi Guemira ,&nbsp;Maher Kharrat ,&nbsp;Marion Leboyer ,&nbsp;Ryad Tamouza","doi":"10.1016/j.encep.2024.04.004","DOIUrl":"10.1016/j.encep.2024.04.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Schizophrenia (SZ) and bipolar disorders (BP) are chronic and severe neuropsychiatric diseases. These disorders are tightly related to immune deregulations. In the current study, we intended to replicate the previously reported involvement of the soluble HLA-E isoforms (sHLA-E) in the risk of developing the two conditions along with disease severity in a Tunisian population group.</div></div><div><h3>Patients and methods</h3><div>One hundred and twenty-four patients with schizophrenia and 121 with bipolar disorder meeting the DSM-IV criteria along 111 healthy controls were included in this present case-control study. The soluble HLA-E isoforms circulating levels were measured using the ELISA method. The statistical analyses were performed using Kruskal-Wallis and Wilcoxon rank sum tests by R software and GraphPad prism 9.</div></div><div><h3>Results</h3><div>We found that the sHLA-E circulating levels were significantly higher in BP patients as compared to healthy controls (<em>P</em> <!-->&lt;<!--> <!-->0.0001) and that such increases were mainly observed in patients during an acute phase of their disease (<em>P</em> <!-->&lt;<!--> <!-->0.0001). In SZ patients, while we failed to observe an association with the levels of sHLA-E in the entire SZ sample, we found that high sHLA-E levels characterized stabilized patients in comparison with those during an acute episode (<em>P</em> <!-->=<!--> <!-->0.022). Finally, we did not observe any association between sHLA-E circulating levels and symptoms assessed by the classical clinical scales either in BP or SZ patients.</div></div><div><h3>Conclusion</h3><div>Overall, the present findings replicate in a Tunisian population group the previously demonstrated implication of sHLA-E circulating levels in the risk of developing BP or SZ in a French patient cohort. Such replication allows to consider HLA-E as a potent and true inflammatory marker in the context of the two disorders.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 261-266"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141187209","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":"Rethinking depression in women: Integrating sex-specific risk factors and treatments","authors":"Hugo Bottemanne ,&nbsp;Lucie Joly ,&nbsp;Caroline Sevoz-Couche ,&nbsp;Emmanuelle Corruble","doi":"10.1016/j.encep.2025.04.001","DOIUrl":"10.1016/j.encep.2025.04.001","url":null,"abstract":"","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 225-226"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014092","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":"Treatment resistant depression: A case of Muenke syndrome","authors":"Mélanie Faugere ,&nbsp;Michel Cermolacce ,&nbsp;Raphaëlle Richieri ,&nbsp;Christophe Lançon","doi":"10.1016/j.encep.2024.10.006","DOIUrl":"10.1016/j.encep.2024.10.006","url":null,"abstract":"<div><div>Major depressive disorder is a complex neuropsychiatric disorder and one of the leading causes of disability in developed countries. Treatment-resistant depression is defined as the failure of at least two adequate treatment trials. The Muenke Syndrome is an autosomal dominant disorder caused by a mutation of the fibroblast growth factor receptor 3 (FGFR3). The fibroblast growth factor (FGF) family has often been implicated in mood disorders in the literature. We present here the case of a patient with a treatment-resistant depression and a concomitant Muenke Syndrome. We propose a relationship between the two pathologies as the expression of the FGF family has been shown to be dysregulated in depressed humans, post-mortem depressed human's brains and rodent's models of depression and anxiety. In particular, FGFR3 and its major ligand, FGF9, had been shown to be down-regulated and up-regulated, respectively, in cortical areas implicated in mood disorders. Since the FGF family plays a key role in neurodevelopment and neuroplasticity, among others things, a genetic mutation in a member of the family, such as FGFR3, could lead to depressive symptoms, as in our reported case. The implication is that the FGF family may be an important target for the treatment of neuropsychiatric disorders. We also conclude that depressive symptoms should be investigated in cases of Muenke Syndrome, as FGF dysregulation in depressed patients.</div></div>","PeriodicalId":51042,"journal":{"name":"Encephale-Revue De Psychiatrie Clinique Biologique et Therapeutique","volume":"51 3","pages":"Pages 342-344"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374965","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}