Pulmonology最新文献

{"title":"Launching a debate: Physical activity in people with chronic respiratory diseases.","authors":"Mara Paneroni, Michele Vitacca, Nicolino Ambrosino","doi":"10.1080/25310429.2024.2445408","DOIUrl":"https://doi.org/10.1080/25310429.2024.2445408","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2445408"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877980","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":"Effect of exercise training on modulating the TH17/TREG imbalance in individuals with severe COPD: A randomized controlled trial.","authors":"Juliana Tiyaki Ito, Luan Henrique Vasconcelos Alves, Luana de Mendonça Oliveira, Rafaella Fagundes Xavier, Regina Maria Carvalho-Pinto, Iolanda de Fátima Lopes Calvo Tibério, Maria Notomi Sato, Celso R F Carvalho, Fernanda Degobbi Tenorio Quirino Dos Santos Lopes","doi":"10.1080/25310429.2024.2441069","DOIUrl":"https://doi.org/10.1080/25310429.2024.2441069","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) induces an imbalance in T helper (Th) 17/regulatory T (Treg) cells that contributes to of the dysregulation of inflammation. Exercise training can modulate the immune response in healthy subjects.</p><p><strong>Objective: </strong>We aimed to evaluate the effects of exercise training on Th17/Treg responses and the differentiation of Treg phenotypes in individuals with COPD.</p><p><strong>Methods: </strong>This randomized controlled trial included 50 individuals with severe or very severe COPD who were allocated to the Exercise or Control groups. The Exercise group underwent eight weeks of aerobic and muscle strength training, whereas the Control group received usual care. The primary outcome was the change in the phenotypic characteristics of Tregs and Th17 profile differentiation in systemic inflammation.</p><p><strong>Results: </strong>Exercise training increased the frequency of total and activated Tregs and decreased the frequency of Th17 cells in between-group comparisons. Additionally, Th17/Treg responses were moderately correlated with improvements in the six-minute walking test, muscle strength of the upper and lower limbs, and daily life physical activity levels.</p><p><strong>Conclusion: </strong>Exercise training improved functional exercise capacity, muscle strength, and physical fitness, which was associated with a decrease in the Th17 inflammatory response and an increase in Treg cell phenotypes immunosuppressive activity.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2441069"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958598","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":"Issue 3-The occupational burden of respiratory diseases, an update.","authors":"N Murgia, M Akgun, P D Blanc, J T Costa, S Moitra, X Muñoz, K Toren, A J Ferreira","doi":"10.1016/j.pulmoe.2024.03.004","DOIUrl":"10.1016/j.pulmoe.2024.03.004","url":null,"abstract":"<p><strong>Introduction and aims: </strong>Workplace exposures are widely known to cause specific occupational diseases such as silicosis and asbestosis, but they also can contribute substantially to causation of common respiratory diseases. In 2019, the American Thoracic Society (ATS) and the European Respiratory Society (ERS) published a joint statement on the occupational burden of respiratory diseases. Our aim on this narrative review is to summarise the most recent evidence published after the ATS/ERS statement as well as to provide information on traditional occupational lung diseases that can be useful for clinicians and researchers.</p><p><strong>Results: </strong>Newer publications confirm the findings of the ATS/ERS statement on the role of workplace exposure in contributing to the aetiology of the respiratory diseases considered in this review (asthma, COPD, chronic bronchitis, idiopathic pulmonary fibrosis, hypersensitivity pneumonitis, infectious pneumonia). Except for COPD, chronic bronchitis and infectious pneumonia, the number of publications in the last 5 years for the other diseases is limited. For traditional occupational lung diseases such as silicosis and asbestosis, there are old as well as novel sources of exposure and their burden continues to be relevant, especially in developing countries.</p><p><strong>Conclusions: </strong>Occupational exposure remains an important risk factor for airways and interstitial lung diseases, causing occupational lung diseases and contributing substantially in the aetiology of common respiratory diseases. This information is critical for public health professionals formulating effective preventive strategies but also for clinicians in patient care. Effective action requires shared knowledge among clinicians, researchers, public health professionals, and policy makers.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416808"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869547","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":"Association of pectoralis muscle area on computed tomography with airflow limitation severity and respiratory outcomes in COPD: A population-based prospective cohort study.","authors":"K Zhou, F Wu, N Zhao, Y Zheng, Z Deng, H Yang, X Wen, S Xiao, C Yang, S Chen, Y Zhou, P Ran","doi":"10.1016/j.pulmoe.2023.02.004","DOIUrl":"10.1016/j.pulmoe.2023.02.004","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown that patients with chronic obstructive pulmonary disease (COPD) of severe or very severe airflow limitation have a reduced pectoralis muscle area (PMA), which is associated with mortality. However, whether patients with COPD of mild or moderate airflow limitation also have a reduced PMA remains unclear. Additionally, limited evidence is available regarding the associations between PMA and respiratory symptoms, lung function, computed tomography (CT) imaging, lung function decline, and exacerbations. Therefore, we conducted this study to evaluate the presence of PMA reduction in COPD and to clarify its associations with the referred variables.</p><p><strong>Methods: </strong>This study was based on the subjects enrolled from July 2019 to December 2020 in the Early Chronic Obstructive Pulmonary Disease (ECOPD) study. Data including questionnaire, lung function, and CT imaging were collected. The PMA was quantified on full-inspiratory CT at the aortic arch level using predefined -50 and 90 Hounsfield unit attenuation ranges. Multivariate linear regression analyses were performed to assess the association between the PMA and airflow limitation severity, respiratory symptoms, lung function, emphysema, air trapping, and the annual decline in lung function. Cox proportional hazards analysis and Poisson regression analysis were used to evaluate the PMA and exacerbations after adjustment.</p><p><strong>Results: </strong>We included 1352 subjects at baseline (667 with normal spirometry, 685 with spirometry-defined COPD). The PMA was monotonically lower with progressive airflow limitation severity of COPD after adjusting for confounders (vs. normal spirometry; Global Initiative for Chronic Obstructive Lung Disease [GOLD] 1: β=-1.27, P=0.028; GOLD 2: β=-2.29, P<0.001; GOLD 3: β=-4.88, P<0.001; GOLD 4: β=-6.47, P=0.014). The PMA was negatively associated with the modified British Medical Research Council dyspnea scale (β=-0.005, P=0.026), COPD Assessment Test score (β=-0.06, P=0.001), emphysema (β=-0.07, P<0.001), and air trapping (β=-0.24, P<0.001) after adjustment. The PMA was positively associated with lung function (all P<0.05). Similar associations were discovered for the pectoralis major muscle area and pectoralis minor muscle area. After the 1-year follow-up, the PMA was associated with the annual decline in the post-bronchodilator forced expiratory volume in 1 s percent of predicted value (β=0.022, P=0.002) but not with the annual rate of exacerbations or the time to first exacerbation.</p><p><strong>Conclusion: </strong>Patients with mild or moderate airflow limitation exhibit a reduced PMA. The PMA is associated with airflow limitation severity, respiratory symptoms, lung function, emphysema, and air trapping, suggesting that PMA measurement can assist with COPD assessment.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416782"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9444917","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":"Effects of asymmetric nasal high-flow cannula on carbon dioxide in hypercapnic patients: A randomised crossover physiological pilot study.","authors":"Lara Pisani, Maria Laura Vega, Elisa Ageno, Irene Prediletto, Roberto Dongilli, Vito Catalanotti, Gilda Giancotti, Stefano Nava","doi":"10.1080/25310429.2024.2411813","DOIUrl":"10.1080/25310429.2024.2411813","url":null,"abstract":"<p><p>Nasal high flow (NHF) therapy is an established form of non invasive respiratory support used in acute and chronic care. Recently, a new high flow nasal cannula with asymmetric prongs was approved for clinical use. The clinical benefits of the new cannula have not yet been defined and no evidence are available on the use of asymmetric NHF support in patient with Chronic Obstructive Pulmonary Disease (COPD). We conducted a single-centre, prospective, physiologic, crossover, randomised study to investigate the effects on partial pressure of carbon dioxide (PaCO²) levels of two different nasal cannula (\"asymmetric\" vs \"standard\" nasal interface) in 20 COPD hypercapnic patients. All patients were recovering from an acute exacerbation that required hospitalisation and had persistent hypercapnia, despite having attained a stable pH. After enrolment, two 90-min trials with the asymmetric nasal high flow interface (Optiflow + Duet, Fisher & Paykel Healthcare Ltd., New Zealand) or the standard interface (Optiflow, Fisher & Paykel Healthcare Ltd., New Zealand) were randomly applied and a washout period of 60 min between the two treatments was performed for minimising the carryover effect. Study results suggested that the asymmetrical cannula did not significantly decrease PaCO² compared with the standard cannula. Similar performances were also observed in terms of diaphragm activity, dyspnoea and patient's comfort. Interestingly, asymmetric NHF cannula performed significantly better in reducing the dead space ventilation and increasing the ventilatory efficiency in more advanced COPD patients with more severe hypercapnia higher baseline PaCO² values (PaCO² ≥ 65 mmHg at baseline).   .</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2411813"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069719","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":"Physiological effects of nasal high flow therapy during exercise in patients with chronic obstructive pulmonary disease: A crossover randomised controlled trial.","authors":"Tristan Bonnevie, Francis-Edouard Gravier, Pauline Smondack, Emeline Fresnel, Isabelle Rivals, Helena Brunel, Yann Combret, Clément Médrinal, Guillaume Prieur, Fairuz Boujibar, Thomas Similowski, Jean-François Muir, Antoine Cuvelier, Maxime Patout","doi":"10.1080/25310429.2024.2424649","DOIUrl":"10.1080/25310429.2024.2424649","url":null,"abstract":"<p><strong>Background: </strong>Nasal high flow (NHF) has been proposed to sustain high intensity exercise in people with COPD, but we have a poor understanding of its physiological effects in this clinical setting.</p><p><strong>Research question: </strong>What is the effect of NHF during exercise on dynamic respiratory muscle function and activation, cardiorespiratory parameters, endurance capacity, dyspnoea and leg fatigue as compared to control intervention.</p><p><strong>Study design and methods: </strong>Randomized single-blind crossover trial including COPD patients. Two constant workload exercise testing were performed at 75% of peak power with NHF (30L/min, 34°C) or with control intervention. Pressure time product of the transdiaphragmatic pressure (PTPdi/min) and other physiological measurements were continuously monitored. Dyspnoea and lower limb fatigue were assessed using the 10-Borg scale.</p><p><strong>Results: </strong>14 patients with severe obstruction (median FEV1: 40 (IQR 28 to 52) %) were included. Their median age was 70 (IQR 57 to 72) years. At isotime, NHF had little to no effect on PTPdi/min (MD -15cmH2O.s/min, 95% CI -62 to 33) but increased tidal volume (MD 77mL, 95% CI 21 to 133). NHF also improved endurance capacity (MD 20s, 95% CI 2 to 40) and dyspnoea at isotime (MD -1.1, 95% CI -2.1 to -0.1). NHF had no or uncertain effect on other outcomes.</p><p><strong>Conclusion: </strong>NHF has little to no effect on dynamic respiratory muscle function and activation but improves Vt. It leads to a trivially small increase in endurance capacity but a worthwhile improvement in dyspnoea. NHF may be beneficial for individuals experiencing critical inspiratory constraints and significant dyspnoea.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2424649"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069263","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":"Successful use of enteric alectinib in a critically ill patient with metastatic ALK-adenocarcinoma: A case report.","authors":"Maria Braganca, Inês Fernandes Pedro, André Santos Nunes, Fernanda Paula, Filipe Froes, Filipa Ferro, Paula Alves","doi":"10.1080/25310429.2025.2523218","DOIUrl":"10.1080/25310429.2025.2523218","url":null,"abstract":"<p><p>Lung cancer is the most prevalent and the leading cause of cancer-related deaths worldwide, with approximately 40% of non-small cell lung cancer cases diagnosed at metastatic stages. Lung cancer patients frequently require intensive care, and while associated with significant mortality, initiating anti-cancer treatments during hospitalisation - particularly tyrosine kinase inhibitors (TKIs) - can improve outcomes due to their high efficacy and tolerability. We report a case of a young, non-smoker, treatment-naïve metastatic lung adenocarcinoma patient who presented with rapid respiratory decline. During admission, molecular testing confirmed the presence of Anaplastic lymphoma kinase rearrangement, and the patient began alectinib. During the stay in intensive care and following mechanical ventilation, alectinib was administered via nasogastric tube, achieving clinical improvement. The patient was discharged and sustained partial response was observed at six months. This highlights the potential for TKI therapy even in critically ill patients.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2523218"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546163","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":"Technological features of smartphone apps for physical activity promotion in patients with CxsOPD: A systematic review.","authors":"J Silva, N Hipólito, P Machado, S Flora, J Cruz","doi":"10.1016/j.pulmoe.2023.06.005","DOIUrl":"10.1016/j.pulmoe.2023.06.005","url":null,"abstract":"<p><strong>Introduction: </strong>Low physical activity (PA) levels have a negative impact on the health status of patients with Chronic Obstructive Pulmonary Disease (COPD). Smartphone applications (apps) focused on PA promotion may mitigate this problem; however, their effectiveness depends on patient adherence, which can be influenced by the technological features of the apps. This systematic review identified the technological features of smartphone apps aiming to promote PA in patients with COPD.</p><p><strong>Methods: </strong>A literature search was performed in the databases ACM Digital Library, IEEE Xplore, PubMed, Scopus and Web of Science. Papers including the description of a smartphone app for PA promotion in patients with COPD were included. Two researchers independently selected studies and scored the apps features based on a previously developed framework (38 possible features).</p><p><strong>Results: </strong>Twenty-three studies were included and 19 apps identified, with an average of 10 technological features implemented. Eight apps could be connected to wearables to collect data. The categories '<i>Measuring and monitoring'</i> and '<i>Support and Feedback'</i> were present in all apps. Overall, the most implemented features were '<i>progress in visual format</i>' (<i>n</i> = 13), '<i>advice on PA'</i> (<i>n</i> = 14) and '<i>data in visual format'</i> (<i>n</i> = 10). Only three apps included social features, and two included a web-based version of the app.</p><p><strong>Conclusions: </strong>The existing smartphone apps include a relatively small number of features to promote PA, which are mostly related to monitoring and providing feedback. Further research is warranted to explore the relationship between the presence/absence of specific features and the impact of interventions on patients' PA levels.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":" ","pages":"2416796"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9739171","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":"Daily digital biomarkers in the follow-up and clustering of patients with asthma.","authors":"Bernardo Sousa-Pinto, Florence Schleich, Gilles Louis, Bilun Gemicioglu, Violeta Kvedarienė, Frederico S Regateiro, Claudia Chaves Loureiro, Luis Taborda-Barata, Rita Amaral, Josep M Antó, Anna Bedbrook, Wienczyslawa Czarlewski, Ignacio J Ansotegui, Karl-C Bergmann, Matteo Bonini, Apostolos Bossios, Louis-Philippe Boulet, Fulvio Braido, Christopher Brightling, Guy Brusselle, Luisa Brussino, G Walter Canonica, Alvaro A Cruz, Tari Haahtela, Liam G Heaney, Michael Hyland, Juan Carlos Ivancevich, Ludger Klimek, Marek Kulus, Piotr Kuna, Maciej Kupczyk, Desiree E Larenas-Linnemann, Michael Makris, Manuel Marques-Cruz, Sara Gil-Mata, Mário Morais-Almeida, Marek Niedoszytko, Markus Ollert, Nikolaos G Papadopoulos, Vincenzo Patella, Oliver Pfaar, Celeste Porsbjerg, Francesca Puggioni, Santiago Quirce, Carlos Robalo Cordeiro, Nicolas Roche, Boleslaw Samolinski, Joaquin Sastre, Nicola Scichilone, Sabina Skrgat, Sanna Toppila-Salmi, Omar S Usmani, Arunas Valiulis, Brigita Gradauskiene, Ilgim Vardaloğlu Koyuncu, Maria Teresa Ventura, Rafael José Vieira, Arzu Yorgancioglu, João A Fonseca, Torsten Zuberbier, Benoit Pétré, Renaud Louis, Jean Bousquet","doi":"10.1080/25310429.2025.2532980","DOIUrl":"10.1080/25310429.2025.2532980","url":null,"abstract":"<p><strong>Background and research question: </strong>We aimed to assess whether levels of digital biomarkers can reflect monthly patterns of asthma control.</p><p><strong>Study design and methods: </strong>We performed a longitudinal study on patients with asthma and comorbid rhinitis who filled ≥26 days of data in a month in the MASK-air® app and who reported at least 1 day of treatment with an inhaled corticosteroid with or without a long-acting β₂-agonist (ICS ± LABA). We applied k-means cluster analysis to define clusters of months according to daily asthma control and medication use. Clusters were compared using digital biomarkers (visual analogue scale [VAS] on asthma symptoms and electronic daily asthma control score [e-DASTHMA]). We compared patients who did not switch with patients who switched their ICS ± LABA.</p><p><strong>Results: </strong>We assessed 243 patients and 1358 months. We identified three clusters of poor asthma control despite high ICS ± LABA adherence, one cluster of poor asthma control and poor ICS ± LABA adherence, one cluster of good asthma control and high ICS ± LABA adherence and one cluster of good asthma control despite poor ICS ± LABA adherence. These clusters displayed relevant differences in VAS asthma and e-DASTHMA levels. Similar clusters were found in 'non-switchers' <i>versus</i> 'switchers'.</p><p><strong>Conclusion: </strong>Levels of digital biomarkers reflect asthma control patterns and might be used to monitor patients with asthma.</p>","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2532980"},"PeriodicalIF":6.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735264","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":"Correspondence: Predicting treatment response to adjuvant platinum-based chemotherapy and prognosis following pulmonary adenocarcinoma surgery.","authors":"Xiping Shen, Ji Wu","doi":"10.1080/25310429.2024.2411803","DOIUrl":"https://doi.org/10.1080/25310429.2024.2411803","url":null,"abstract":"","PeriodicalId":54237,"journal":{"name":"Pulmonology","volume":"31 1","pages":"2411803"},"PeriodicalIF":10.4,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069672","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}