Journal of the American Academy of Orthopaedic Surgeons最新文献

{"title":"Anterior Cruciate Ligament Injury in Skeletally Immature Patients.","authors":"Anthony C Egger, Shital N Parikh","doi":"10.5435/JAAOS-D-23-00848","DOIUrl":"10.5435/JAAOS-D-23-00848","url":null,"abstract":"<p><p>The incidence of anterior cruciate ligament (ACL) injury continues to increase in the skeletally immature population. These injuries were historically treated with nonsurgical measures in this age group due to concerns for iatrogenic damage to the physis during ACL reconstruction. However, delayed surgery often led to recurrent instability, meniscal tears, and chondral damage. With the development of newer and safer surgical techniques with satisfactory outcomes, ACL reconstruction has become much more common in this age group. The patient's skeletal age is often used to determine remaining growth, which helps to decide the surgical technique chosen. These techniques include physeal sparing, partial transphyseal, and transphyseal surgical options, using soft-tissue autografts. Each technique has been shown to have favorable patient-reported outcomes, but no technique is without the risk of complications. This article will review the management of skeletally immature ACL injuries, including relevant anatomy, risk factors for injury, assessment of skeletal age, and different treatment options and outcomes.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"e259-e273"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Representation Matters: A Higher Percentage of Women Orthopaedic Surgery Faculty Is Associated With an Increased Number of Women Residents.","authors":"Rachel Ranson, Kassidy Webber, Christopher Saker, Isabella Cashin, Josie L Bunstine, Aaditya P Patel, Julia Kirkland, Arianna L Gianakos, Mia V Rumps, Mary K Mulcahey","doi":"10.5435/JAAOS-D-24-00469","DOIUrl":"10.5435/JAAOS-D-24-00469","url":null,"abstract":"<p><strong>Introduction: </strong>Orthopaedic surgery has been recognized as one of the least diverse surgical specialties. Previous studies have demonstrated that women are heavily underrepresented within orthopaedic surgery. The purpose of this study was to determine whether orthopaedic surgery residency programs with a higher presence of women faculty had a higher proportion of women residents.</p><p><strong>Methods: </strong>The Fellowship and Residency Electronic Interactive Database was used to identify all orthopaedic surgery residency programs in the United States. Resident and faculty's sex and degree were recorded in addition to faculty administrative title (eg, program director, chair) and academic rank (clinician, professor, etc). Pearson correlation coefficients were used to compare the number of women residents with the number of women faculty.</p><p><strong>Results: </strong>A total of 192 orthopaedic surgery programs were analyzed. Of the 5,747 faculty members and 4,268 residents identified, 13.1% (n = 752) and 22.6% (n = 963) were women, respectively. The number of women residents markedly correlated with the number of women faculty in leadership positions (r = 0.516, P < 0.001), such as chief or chair. The most significant correlations were among women with the academic role of \"professor\" (r = 0.575, P < 0.001), \"assistant professor\" (r = 0.555, P < 0.001), and women who held faculty positions but held no higher academic appointment (r = 0.509, P < 0.001). Program directors and assistant program directors were not found to have significant correlations with the number of women residents.</p><p><strong>Conclusion: </strong>This study demonstrates a positive correlation between women faculty and residents at orthopaedic surgery residencies. Some academic positions, such as division chief, held more significant associations, whereas other positions, such as professor emeritus, were not held by any women, thereby limiting statistical analysis. Further investigation into minority representation in orthopaedic surgery and initiatives to address the observed disparities is paramount.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"253-260"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Path to Success: An Analysis of the Subjective and Objective Characteristics of Orthopaedic Surgery Applicants With Program Director Insight.","authors":"Abtahi Tishad, Jonathan D Kass, Griffin Stinson, Andre Spiguel","doi":"10.5435/JAAOS-D-24-00421","DOIUrl":"10.5435/JAAOS-D-24-00421","url":null,"abstract":"<p><p>At present, there is uncertainty regarding the objective and subjective characteristics of competitive applicants for orthopaedic surgery residency (OSR). With the hope of enlightening future applicants and their orthopaedic surgeon mentors on what factors they ought to emphasize to successfully match into an OSR program, we summarized and analyzed the characteristics of OSR applicants between the 2020 and 2023 residency application cycles using data from the Texas Seeking Transparency in Application to Residency (STAR) database and insights from the 2020 National Resident Matching Program (NRMP) program director (PD) Survey. Factors considered in our analysis include standardized examination scores, class quartile, research output, extracurricular activities, and application characteristics, such as number of programs applied to, number of interviews attended, and match outcome. To elucidate the importance of more nonquantifiable metrics, we analyzed 423 subjective comments from OSR applicants found in the STAR database and compared them with relevant findings from the 2020 NRMP PD Survey. Of the 1,094 OSR applicants identified, 926 matched and 168 did not match, yielding a match rate of 84.64%. Matched applicants had markedly higher board examination scores, were more likely to be in the first and second quartiles of their class, had a higher number of honored clerkships, were more likely to have Alpha Omega Alpha (AOA) membership, and overall had more research, volunteer, and leadership experiences. Our logistics regression analysis showed that being in the first quartile had the greatest effect on odds of matching, sequentially followed by having a United States Medical Licensing Examination step 2 score above 250, having more leadership opportunities, and finally, more total research output. With respect to nonquantifiable metrics, applicants and PDs alike heavily emphasized performing well on subinternships and having desirable personal attributes such as a strong work ethic, willingness to learn, and understanding the importance of teamwork.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"e274-e290"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Dexamethasone Administration During Total Hip and Knee Arthroplasty Safe in Diabetic Patients?","authors":"Kareem J Kebaish, Jennifer C Wang, Amit S Piple, Julian Wier, Kevin C Liu, Alexander B Christ, Nathanael D Heckmann","doi":"10.5435/JAAOS-D-23-00513","DOIUrl":"10.5435/JAAOS-D-23-00513","url":null,"abstract":"<p><strong>Introduction: </strong>Dexamethasone is used extensively during total hip and knee arthroplasty total joint arthroplasty (TJA) to control pain and decrease the risk of nausea and vomiting. However, the safety of dexamethasone utilization in diabetic patients is poorly understood. Therefore, this study aims to evaluate complications associated with perioperative dexamethasone administration during primary TJA in diabetic patients.</p><p><strong>Methods: </strong>The Premier Healthcare Database was queried for all patients with diabetes mellitus who underwent primary elective TJA from 2015 to 2020. Patients who received intravenous dexamethasone on the day of surgery were compared with those who did not. Patient characteristics, hospital factors, and rates of medical comorbidities were assessed and compared between the cohorts. Multivariate logistic regression was done to assess the 90-day risk of infectious and noninfectious postoperative complications.</p><p><strong>Results: </strong>Overall, 261,474 diabetic patients were included for analysis, 122,631 (46.9%) of whom received dexamethasone. The two cohorts were similar in patient demographics, hospital characteristics, and comorbidity burden (absolute range of differences: 0.00 to 2.33%). Diabetic patients who received dexamethasone had decreased odds of periprosthetic joint infection (adjusted odds ratio 0.82, 95%-CI: 0.75 to 0.90, P < 0.001) and sepsis (aOR: 0.80, 95%-CI: 0.72 to 0.89, P < 0.001) compared with those who did not. Patients who received dexamethasone had shorter length of stay compared with those who did not (1.87 ± 1.60 days vs. 2.27 ± 1.88 days, P < 0.001). The adjusted odds of postoperative hyperglycemia were markedly higher in the dexamethasone group (aOR: 1.14, 95%-CI: 1.10 to 1.18, P < 0.001).</p><p><strong>Conclusion: </strong>Use of perioperative dexamethasone was not associated with the increased risk of infectious complications among diabetic patients undergoing TJA, supporting its safety in this high-risk population.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"242-252"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refined Techniques in Tibial Nailing.","authors":"Cory A Collinge, Mariel M Rickert, Phillip M Mitchell, Robert H Boyce","doi":"10.5435/JAAOS-D-24-00238","DOIUrl":"10.5435/JAAOS-D-24-00238","url":null,"abstract":"<p><p>Intramedullary nail fixation of unstable tibial diaphyseal fractures is commonly used with excellent clinical results. Indications for nailing have rapidly expanded over recent years, allowing for more difficult fractures to be addressed with \"extreme nailing.\" Despite its widespread use, evolution of newer nailing systems and varying techniques for insertion bring new difficulties with tibial fracture reduction, and malalignment occurs with relative frequency. This highlights the need for a methodical approach for efficient and predictable tibial nailing. An algorithmic approach is essential, beginning with identifying challenging patterns in proximal and distal fractures and addressing any intra-articular elements initially. A semiextended approach is helpful to neutralize deforming forces. Optimizing the starting point and confirming lateral termination of the guidewire mitigate fracture malreduction after nail placement. Fracture reduction is facilitated with clamps, fibular or tibial plating, blocking screws or wires, external fixation, universal distractor, or manual manipulation to optimize outcomes and avoid pitfalls in an effective tibial nailing.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"e291-e300"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comprehensive Review of Injury Causation Analysis Methodology for the Assessment of Workers' Compensation and Motor Vehicle Collision Injuries.","authors":"Erick M Santos, Richard A Watson, Alexis E Dixon, Peter G Whang","doi":"10.5435/JAAOS-D-24-00112","DOIUrl":"10.5435/JAAOS-D-24-00112","url":null,"abstract":"<p><p>Orthopaedic surgeons are frequently involved in treating patients with conditions resulting from occupational injuries or trauma from motor vehicle collisions. These circumstances may lead to disputes that are subject to litigation or medicolegal determinations by state agencies. As musculoskeletal experts, orthopaedic surgeons are frequently asked to opine on the causation and extent of injury in these patients. This comprehensive review details the methodology for injury causation analysis, which has been developed and validated in the peer-reviewed literature. These approaches evolved from the Hill criteria to encompass protocols used by the American Medical Association and taught at the American Academy of Orthopaedic Surgeons instructional courses. The various methodologies are defined in the context of their use for workers' compensation cases and motor vehicle collisions with the assistance of an illustrative case.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"212-220"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing and Preserving Tattoos During Orthopaedic Surgery.","authors":"Shafic Sraj, Brendan Farley, Acara Turner, Kerri Woodberry","doi":"10.5435/JAAOS-D-24-00596","DOIUrl":"10.5435/JAAOS-D-24-00596","url":null,"abstract":"<p><p>Orthopaedic surgeons encounter tattoos in surgical fields with an increasing frequency and have the choice of avoiding, disregarding, bordering, or incorporating them into the surgical incisions. This article describes the history and the personal, social, and artistic value of tattoos; the physiology of tattoos and wound healing; the principles of incision planning for optimal cosmesis; and specific considerations when encountering tattoos in the surgical field. It subsequently describes cosmetic outcomes and tattoo-specific complications after surgery and provides a decision tree to help surgeons and patients decide the best approach for individual situations.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"221-230"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D Supplementation May Prevent or Treat Deficiency After Total Knee Arthroplasty: A Retrospective Cohort Analysis.","authors":"Jessica L Duggan, Matthew P Jamison, Wolfgang Fitz, Jeffrey K Lange, Meryl S LeBoff, Antonia F Chen","doi":"10.5435/JAAOS-D-24-00005","DOIUrl":"10.5435/JAAOS-D-24-00005","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D deficiency is associated with poorer functional outcomes and increased complication rates after total knee arthroplasty (TKA). Yet, there is no longer term study evaluating vitamin D levels and supplementation after TKA. Our study aimed to compare quantitative vitamin D levels and supplementation regimens after TKA stratified by patient sex and race.</p><p><strong>Methods: </strong>A retrospective cohort study of primary TKA patients at a single hospital from 2015 to 2022 was conducted. We analyzed vitamin D preoperatively and postoperatively up to 2 years. Vitamin D deficiency was defined as <30 ng/mL. A subgroup analysis was conducted in patients with vitamin D <21 ng/mL. Supplementation categories included none, low (<1,001 IU), medium (1,001 to 5,000 IU), and high (>5,000 IU).</p><p><strong>Results: </strong>A total of 400 (66.0% female) patients who underwent 430 primary TKA procedures were included, and 65.3% received supplementation. Patients who were vitamin D sufficient preoperatively demonstrated higher vitamin D levels and ability to maintain sufficiency postoperatively using low-dose supplementation compared with no supplementation ( P = 0.004). Those who were vitamin D deficient preoperatively demonstrated higher vitamin D levels postoperatively using medium to high doses ( P = 0.02). For patients who became deficient postoperatively, supplementation was associated with achieving repletion at an average of 10.2 months ( P < 0.001). Black patients demonstrated 2.8 times higher odds of having a vitamin D level less than 30 ng/mL ( P = 0.03).</p><p><strong>Conclusion: </strong>Our study demonstrated that low-dose vitamin D supplementation (<1,001 IU) was beneficial for vitamin D-sufficient TKA patients to achieve higher levels and maintain vitamin D sufficiency. Vitamin D-deficient TKA patients benefitted from medium-to-high dose supplementation (1,001 to 5,000+), but only 33.7% achieved vitamin D repletion. This work highlights the need to continue vitamin D surveillance postoperatively and the need to continue vitamin D repletion.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"e301-e311"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141728263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Time and Rate of Achieving Minimal Clinically Important Difference: Robotic Versus Manual Unicompartmental Knee Arthroplasty.","authors":"Perry L Lim, Zain Sayeed, Marcos R Gonzalez, Christopher M Melnic, Hany S Bedair","doi":"10.5435/JAAOS-D-24-00380","DOIUrl":"10.5435/JAAOS-D-24-00380","url":null,"abstract":"<p><strong>Background: </strong>Robotics in unicompartmental knee arthroplasty (UKA) continues to increase with the ever-growing demand to use technology in the surgical setting. However, no studies have used minimal clinically important difference (MCID) to compare patient-reported outcome measures (PROMs) between robotic UKA (rUKA) and manual UKA (mUKA). This study aimed to compare the rate of achieving MCID for improvement (MCID-I) and worsening (MCID-W) and the time to achieving MCID.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of robotic and manual UKAs performed between 2016 and 2022. Preoperative and postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) Global Physical, PROMIS Physical Function Short-Form 10a (PF-10a), and Knee Injury and Osteoarthritis Outcome Score-Physical Function Short-Form (KOOS-PS) scores were collected. Patients were stratified on reaching MCID-I, MCID-W, or \"no notable change\" (score between MCID-W and MCID-I). Survival curves with and without interval censoring were used to assess the time to achieving the MCID. Log-rank and weighted log-rank tests were used to compare groups.</p><p><strong>Results: </strong>A total of 256 UKAs (64 robotic and 192 manual) were analyzed. No differences were observed in the proportion of patients achieving MCID-I or MCID-W across all three PROMs. Similarly, median time to achieving MCID showed no significant differences between rUKA and mUKA for PROMIS Global Physical (3.3 versus 4.9 months, P = 0.44), PROMIS PF-10a (7.7 versus 8.3 months, P = 0.93), and KOOS-PS (3.0 versus 6.0 months, P = 0.055) scores, both with and without interval censoring.</p><p><strong>Discussion: </strong>This study indicates that rUKA and mUKA exhibit comparable rates of achieving MCID-I and MCID-W, along with similar median time to reach MCID. These findings offer valuable patient-centric insights into the effectiveness of rUKA. Additional studies evaluating the long-term outcomes of rUKA are needed to determine its long-term advantages.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"231-241"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative Cardiac Arrest in Orthopaedic Surgery: A Case Series of 42 Patients.","authors":"Aleksander P Mika, Robert B Ponce, Sean P Wrenn, Joshua M Lawrenz, Daniel J Stinner, Phillip M Mitchell","doi":"10.5435/JAAOS-D-24-00359","DOIUrl":"10.5435/JAAOS-D-24-00359","url":null,"abstract":"<p><strong>Introduction: </strong>Intraoperative cardiac arrest (IOCA) is a rare event during orthopaedic surgery. Although infrequent, it has a notable effect, with mortality as high as 35%. Little is known about the outcomes of IOCA in orthopaedic surgery, and this study aims to fill that knowledge gap to improve patient counseling and treatment decisions.</p><p><strong>Methods: </strong>A retrospective review of a single health system over a 20-year period identified 42 patients who experienced IOCA during orthopaedic surgery. Patient characteristics, procedure details, cardiac event specifics, and postoperative complications with an emphasis on morbidity and mortality were collected.</p><p><strong>Results: </strong>Return of spontaneous circulation (ROSC) was achieved in 88% (37 of 42) of patients. In-hospital death following successful resuscitation occurred in 22% (8 of 37) of patients. In those who survived their hospitalization (29 of 42, 69%), 59% (17 of 29) required additional treatment for medical complications acquired secondary to their arrest. IOCA occurred most often during spinal surgery, intramedullary nailing, and cemented endoprosthetic reconstruction, accounting for one-half of cases. Pulmonary embolism was the most common cause of IOCA. In patients requiring case abortion with rapid closure and a delayed return to the operating room for case completion, the infection rate was 40%.</p><p><strong>Conclusion: </strong>The majority of orthopaedic surgery patients achieve ROSC following IOCA. For patients who achieve ROSC, two-thirds had either subsequent in-hospital death or a long-term medical complication secondary to their arrest. These findings suggest that a cautious prognosis is indicated even after a successful resuscitation.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"261-265"},"PeriodicalIF":2.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}