Regional Anesthesia and Pain Medicine最新文献

{"title":"Infrapatellar branch of saphenous nerve: from anatomy, sonoanatomy to its clinical implications.","authors":"Michael Sj Peng, Steven R Clendenen, Glenn G Shi, Ban C H Tsui","doi":"10.1136/rapm-2025-106383","DOIUrl":"https://doi.org/10.1136/rapm-2025-106383","url":null,"abstract":"<p><p>The infrapatellar branch of the saphenous nerve (IPBSN) is implicated in nerve injury from different knee surgeries because of its intimate course relative to the knee joint capsule. Pain physicians encounter patients in their practice for the management of neuralgia of this nerve or in the context of advanced management of knee osteoarthritis. This article aims to provide a comprehensive review of the anatomy, sonoanatomy, and the intervention of the IPBSN in pain management of infrapatellar neuralgia and chronic knee pain.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525278","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":"Perineuromal hydrodissection for acute postamputation pain? An observational study in a time of war.","authors":"Dmytro Dmytriiev, Winnie Liu, Maksym Barsa, Andreii Khomenko, Andreii Strokan, Paul F Pasquina, Steven P Cohen","doi":"10.1136/rapm-2024-106307","DOIUrl":"10.1136/rapm-2024-106307","url":null,"abstract":"<p><strong>Introduction: </strong>This exploratory study investigates the potential of perineuromal hydrodissection as an adjunct to opioid therapy for postamputation pain, specifically focusing on residual limb and phantom limb pain (PLP). Given the correlations between acute pain and the development of chronic pain, the primary aims were to estimate the effect size of early hydrodissection of scar tissue around residual limb neuroma(s) and to identify the best time frame for treatment.</p><p><strong>Methods: </strong>Seventy-four patients with war-related limb amputations and painful neuromas were included in this observational analysis. Thirty-eight Ukrainian patients with war-related limb amputation and a painful neuroma(s) who underwent hydrodissection and opioid therapy within 6 months of amputation were compared with 36 patients who received opioids alone. Co-primary outcome measures were median reduction from baseline in average residual limb and PLP at 12 weeks. The composite positive outcome was designated as a ≥2-point decrease or 30% reduction in average residual limb and PLP, satisfaction with treatment, and not requiring an increase in analgesics.</p><p><strong>Results: </strong>Hydrodissection as an add-on to opioids resulted in a greater reduction in average residual limb pain at 12 weeks (-2.00±1.00 vs -1.00±1.00; p<0.001) and earlier time periods, but PLP only through 4 weeks. At 12 weeks, Hospital Anxiety and Depression Scale anxiety (10.00±2.00 vs 11.00±1.00; p<0.001) but not depression score was lower in the hydrodissection group. Opioid use in the hydrodissection group significantly declined from 41.32±9.63 to 33.42±8.78 morphine equivalents per day (p=0.001) over the study, but not in the opioid-only group (p=0.20). Differences in 12-week satisfaction rates were not significant.</p><p><strong>Conclusions: </strong>This exploratory study suggests perineuromal hydrodissection may improve residual limb pain and to a lesser degree phantom limb pain, particularly when implemented early in the course of postamputation pain. The study provides preliminary effect size estimates and identifies acute pain as a potential characteristic of patients who may respond more favorably to this intervention. Randomized controlled trials are needed to confirm these findings and control for the confounding variables identified.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460602","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":"Factors associated with poor pain experience after surgery.","authors":"Axel Maurice-Szamburski, Romain Rozier, Victor Gridel, Vladimir Radev, Emmanuelle Badia, Anderson Loundou, Pascal Auquier, Xavier Capdevila","doi":"10.1136/rapm-2024-106095","DOIUrl":"https://doi.org/10.1136/rapm-2024-106095","url":null,"abstract":"<p><strong>Objective: </strong>To identify factors associated with poor postoperative pain experience by examining patient-related and procedural variables.</p><p><strong>Methods: </strong>An exploratory secondary analysis was conducted on data from 971 adult patients undergoing elective surgery under general anesthesia across five French teaching hospitals. Preoperative anxiety was assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Pain, sleep quality and well-being were measured preoperatively and postoperatively using visual analog scales (VAS). The primary endpoint was the patient experience measured by the Evaluation du Vécu de l'Anesthésie Generale (EVAN-G) questionnaire on postoperative day 1, with poor pain experience defined as a score below the 25th percentile on the EVAN-G pain dimension. Univariate and multivariate logistic regression analyses were performed to identify factors associated with poor pain experience.</p><p><strong>Results: </strong>Poor pain experience was reported by 271 patients (27.9%). Multivariate analysis identified intraoperative use of remifentanil and sufentanil as an independent predictor of poor pain experience with an OR of 26.96 (95% CI 2.17 to 334.23, p=0.01). Additionally, age (OR 0.97, p=0.003), absence of premedication (OR 0.49, p=0.035) and orthopedic surgery (OR 0.29, p=0.005) were associated with a lower likelihood of poor pain experience. Conversely, American Society of Anesthesiologists (ASA) 3 status (OR 5.09, p=0.028), postoperative anxiolytic use (OR 8.20, p<0.001), amnesia (OR 1.58, p=0.001), higher VAS pain (p<0.001) and lower well-being scores (p=0.007) on day 1 were predictors of poor pain experience.</p><p><strong>Conclusion: </strong>The intraoperative use of remifentanil and sufentanil is independently associated with poorer postoperative pain experience. These findings highlight the need to reassess intraoperative analgesic strategies to enhance patient outcomes and reduce postoperative complications.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506006","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":"Unrestricted insurance coverage of buprenorphine formulations remains sparse in comparison to conventional opioids.","authors":"Bennett Andrassy, Junaid Mukhdomi, Nidhi Bhaskar, Marcus Harris, Taif Mukhdomi","doi":"10.1136/rapm-2024-106306","DOIUrl":"https://doi.org/10.1136/rapm-2024-106306","url":null,"abstract":"<p><strong>Objective: </strong>Buprenorphine is an atypical opioid with analgesic efficacy and a more favorable safety profile than conventional opioids or tramadol. In 2019, access to on-label buprenorphine formulations was limited in comparison to conventional opioids, despite evidence supporting buprenorphine's first-line analgesic use. Considering recent policy changes increasing buprenorphine accessibility, we determined differences in unrestricted insurance coverage between buprenorphine, conventional opioids, and other atypical opioids.</p><p><strong>Methods: </strong>We used data from Managed Market Insights and Technology's Coverage Search and Kaiser Family Foundation to generate estimates on percentages of US-covered lives with unrestricted access to oxycodone, morphine, tramadol, tapentadol, generic and on-label transdermal buprenorphine, on-label buccal buprenorphine, and on-label sublingual buprenorphine/naloxone in 2024.</p><p><strong>Results: </strong>79.7% of commercial and 99.1% of Medicare lives had unrestricted oxycodone access. Morphine access was unrestricted for 45.7% of commercial and 62.8% of Medicare lives. Unrestricted access to tramadol was available for 88.2% of commercial and 96.3% of Medicare lives. 37.3% of commercial and 10.1% of Medicare lives had unrestricted tapentadol access. Unrestricted access to on-label transdermal buprenorphine was available for 21.0% of commercial and 2.59% of Medicare lives. Generic transdermal buprenorphine was available for 52.1% of commercial and 30.0% of Medicare lives. Buccal buprenorphine was available without restriction for 52.7% of commercial and 19.8% of Medicare lives. Sublingual buprenorphine/naloxone had unrestricted coverage for 34.6% of commercial and 32.7% of Medicare lives.</p><p><strong>Conclusions: </strong>Access to buprenorphine formulations was limited in comparison to other opioids. This study emphasizes a need for commercial and Medicare health insurance plans to broaden buprenorphine coverage.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470104","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":"Letter to the editor: Is medetomidine the next perioperative substance of abuse?","authors":"Aminat Haruna, Boris Anyama, Gaurav Chauhan, Brendan Lynch, Eugene R Viscusi, Trent Emerick","doi":"10.1136/rapm-2024-106152","DOIUrl":"https://doi.org/10.1136/rapm-2024-106152","url":null,"abstract":"","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460598","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":"Cadaveric study of the obturator nerve: frequency of skin innervation and the optimal site for blocking the cutaneous branch.","authors":"Christian Jessen, Bernhard Moriggl, Romed Hörmann, Thomas Fichtner Bendtsen","doi":"10.1136/rapm-2024-106330","DOIUrl":"https://doi.org/10.1136/rapm-2024-106330","url":null,"abstract":"<p><strong>Background: </strong>Clinical understanding of the obturator nerve's cutaneous and motor branches is crucial for performing effective obturator nerve blocks, particularly for procedures involving the thigh and hip. Literature and anatomical references report highly variable patterns of the frequency and cutaneous distribution of obturator nerve innervation.This study examines the frequency and distribution of the cutaneous branch of the anterior ramus of the obturator nerve (cb-ar-ON) and assesses the most effective anatomical sites for nerve blockade.</p><p><strong>Methods: </strong>Dissections were conducted on 14 sides from eight cadavers to identify the presence, branching pattern and innervation areas of the cb-ar-ON. Ultrasound-guided injections of low-volume dye were performed proximally between the adductor longus and gracilis muscles and distally near the great saphenous vein to assess optimal targeting.</p><p><strong>Results: </strong>cb-ar-ON were found in 43% of cadaveric sides, branching off the anterior ramus of the obturator nerve 6-10 cm distal to the inguinal ligament. When present, the cb-ar-ON innervated a 4-9 cm² area in the posteromedial popliteal fossa. Proximal ultrasound-guided blocks targeting the area between the adductor longus and gracilis muscles effectively stained the cb-ar-ON in 100% of cases where the branch was present.</p><p><strong>Conclusion: </strong>The cb-ar-ON provides variable and limited cutaneous innervation, appearing in 43% of cases, primarily in the posteromedial popliteal fossa. Effective blockade can be achieved with a proximal approach between the adductor longus and gracilis muscles.These findings suggest that clinical evaluation of obturator nerve block based on cutaneous anesthesia is unreliable.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460392","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 stellate ganglion block on brain hemodynamics and the inflammatory response in moderate and severe traumatic brain injury: a pilot study.","authors":"Ivan Kostadinov, Jernej Avsenik, Josko Osredkar, Ales Jerin, Primoz Gradisek","doi":"10.1136/rapm-2024-106185","DOIUrl":"https://doi.org/10.1136/rapm-2024-106185","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic brain injury (TBI) is often associated with reduced cerebral blood flow and an increased inflammatory response, leading to secondary brain damage. Stellate ganglion block (SGB) has been shown to improve cerebral hemodynamics in non-TBI, but its effects in TBI are still unclear.</p><p><strong>Objective: </strong>This prospective pilot study investigates the effects of SGB on cerebral hemodynamics and neuroinflammatory responses in patients with moderate to severe TBI with the aim of evaluating its potential as a therapeutic intervention.</p><p><strong>Methods: </strong>A prospective, single-center observational study was conducted in 20 patients with moderate to severe TBI. SGB was performed ipsilateral to the most severely affected hemisphere using an ultrasound-guided lateral approach at the level of C6 with 8 mL 0.5% levobupivacaine. The primary outcome was the change in blood flow velocity in the ipsilateral middle cerebral artery as measured by transcranial color-coded duplex ultrasonography before and after the procedure. Secondary outcomes included changes in (a) the diameter of the basal arteries of the brain as measured by computed angiography tomography; (b) cerebral blood flow, volume and time to peak as measured by computed perfusion tomography; (c) cerebral perfusion pressure, intracranial pressure and brain oxygenation. The changes in the biomarkers of inflammation and brain injury interleukin 6, neuron-specific enolase, protein S100B and glial fibrillar acidic protein measured at baseline, 12 hours and 24 hours after SGB were defined as tertiary outcomes.</p><p><strong>Results: </strong>SGB significantly reduced blood flow velocity in the middle cerebral artery, increased the diameter of the large basal cerebral arteries, improved cerebral blood flow and volume in certain brain regions on the ipsilateral side. Inflammatory markers such as IL-6 and S100B decreased significantly within 24 hours. The intracranial pressure decreased, the cerebral perfusion pressure and the oxygen supply to the brain tissue improved after SGB. No adverse events were observed.</p><p><strong>Conclusion: </strong>SGB modulates cerebral hemodynamics and lowers intracranial pressure in patients with TBI, demonstrating its potential as a neuroprotective intervention. While these results highlight the therapeutic potential of SGB, further randomized controlled trials are needed to determine its optimal use and short-term and long-term benefits in the treatment of TBI.</p><p><strong>Trial registration number: </strong>NCT04208477.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460393","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":"FRONT block: a cadaveric study of a dual-plane injection block targeting femoral rami and obturator nerve trunk for anterior hip joint analgesia.","authors":"Christian Jessen, Siska Bjørn, Romed Hörmann, Hanne-Rose Honis, Thomas Fichtner Bendtsen","doi":"10.1136/rapm-2024-106272","DOIUrl":"https://doi.org/10.1136/rapm-2024-106272","url":null,"abstract":"<p><strong>Background: </strong>The quest for a single nerve block to anesthetize all anterior hip articular nerve branches has long been a challenge for anesthetists, particularly in targeting the obturator nerve (ON). The FRONT block (Femoral Rami Obturator Nerve Trunk) is a newly developed dual-injection technique providing comprehensive anesthetic coverage of the anterior hip joint by targeting both the sensory femoral rami and the ON trunk.</p><p><strong>Methods: </strong>15 intact cadaveric sides from eight embalmed cadavers were dissected after FRONT block administration with one injection and two dye deposits in the iliopsoas plane and in the subpectineal compartment under dynamic ultrasonography. The primary outcome was dye spread to the sensory hip articular branches of the femoral nerve (FN) and the ON trunk evaluated during the gross anatomical dissection. Secondary outcomes included identifying landmarks for accurate injection of dye and measuring the distance from the needle trajectory to the femoral and the lateral femoral cutaneous nerves (LFCN).</p><p><strong>Results: </strong>In 86.7% of cadaver sides, the FRONT block successfully covered both the sensory femoral rami and the ON trunk. The injection was performed 6.7 cm (SD 1.6) distal to the anterior superior iliac spine with a medial deviation of 1.8 cm (SD 2.1). The average distance from the needle trajectory to the FN was 0.8 cm (SD 0.4) and 3.7 (SD 2.1) cm to the LFCN.</p><p><strong>Conclusion: </strong>The FRONT block offers reliable coverage of the anterior hip joint and capsule. Proficiency in ultrasound-guided regional anesthesia is important during clinical applications.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450850","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":"Clinical implication of regional osteopenia in complex regional pain syndrome: a retrospective comparative study.","authors":"Jeongsoo Kim, Hyungsang Rho, Yongjae Yoo, Joon Cha, Sunghoon Park, Hangaram Kim, Sanihah Che Omar, Jee Youn Moon","doi":"10.1136/rapm-2024-106111","DOIUrl":"https://doi.org/10.1136/rapm-2024-106111","url":null,"abstract":"<p><strong>Background: </strong>Despite the significant role of impaired bone metabolism in complex regional pain syndrome (CRPS), the clinical implications of osteopenia remain a focal point of investigation. We examined the prevalence and risk factors of affected limb osteopenia in CRPS and its association with the response to sympathetic blockade.</p><p><strong>Methods: </strong>167 patients with CRPS who underwent CT of their affected limbs were retrospectively reviewed. After conducting univariable analyses where regional osteopenia determined by CT was dependent and other clinical factors were independent variables, the first multivariable analysis assessed risk predictors associated with regional osteopenia in CRPS. Next, after conducting univariable analyses where sympathetic block response was dependent and others, including regional osteopenia, were independent variables, the second multivariable model predicted factors associated with the response to sympathetic blockades, followed by receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>Among 116 patients, regional osteopenia was identified in 72.2% early (<1 year) and 52.5% persistent CRPS. In the first multivariable analysis adjusted for age, sex, body mass index (BMI), and other variables with p values<0.1 from initial univariable analyses, older age (OR 1.06; 95% CI 1.02 to 1.10) and positive three-phase bone scintigraphy (TPBS) (OR 3.94; 95% CI 1.46 to 10.66) were significantly associated with regional osteopenia. In the second multivariable model adjusted for age, sex, BMI, and other variables with p values<0.1 from univariable analyses, early phase (OR 5.49; 95% CI 1.44 to 20.88), regional osteopenia (OR 5.11; 95% CI 1.49 to 17.53), and positive TPBS (OR 6.30; 95% CI 2.21 to 17.93) were significantly associated with positive responses to sympathetic blockade in CRPS, showing excellent performance characteristics with a predicted probability>0.358 (sensitivity 0.86; specificity 0.76).</p><p><strong>Conclusion: </strong>Regional osteopenia in the affected limb can anticipate positive responses to sympathetic blockade when combined with TPBS in early CRPS.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442747","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":"Liposomal bupivacaine: examining the factors behind inconsistent analgesic results.","authors":"Steven L Orebaugh, Mariusz Ligocki, Henry Guo, Hong Chen","doi":"10.1136/rapm-2024-106189","DOIUrl":"https://doi.org/10.1136/rapm-2024-106189","url":null,"abstract":"<p><p>Liposomal bupivacaine (LB) has been the subject of a great deal of study, and some degree of controversy, since its development in the late 1990s. While some published studies are supportive of its efficacy, many others are not or demonstrate only marginal improvement in analgesia. This variable efficacy occurs in the face of markedly increased costs when compared with plain local anesthetics. In this education article, we trace the development of LB, summarize the important aspects of its pharmacology, and explore possible causes of its failure to fulfill the promise that the drug held when it was developed and approved. Finally, we discuss some aspects of perineural anatomy that might impact the potential of this drug to provide long-lasting analgesia.</p>","PeriodicalId":54503,"journal":{"name":"Regional Anesthesia and Pain Medicine","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442779","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}