Kardiologiya最新文献

{"title":"WNT Signaling Cascade Proteins and Structural and Functional State of The Vascular Bed in Patients With Various Phenotypes of Stable Ischemic Heart Disease.","authors":"A O Iusupova, N N Pakhtusov, O A Slepova, E V Privalova, Yu N Belenkov","doi":"10.18087/cardio.2025.3.n2853","DOIUrl":"10.18087/cardio.2025.3.n2853","url":null,"abstract":"<p><p>Aim      To evaluate the concentration of the WNT signaling cascade proteins (WNT1, -3a, -4, -5a) and the state of the vasculature by photoplethysmography (PPG) in patients with different phenotypes of stable ischemic heart disease (IHD), with obstructive and non-obstructive coronary artery disease (CAD).Material and methods  This cross-sectional observational study included 80 patients (45-75 years old) with a verified diagnosis of stable IHD. Based on the results of coronary angiography or multislice spiral computed tomography coronary angiography, the patients were divided into two equal groups (n=40), with obstructive IHD (oIHD), and ischemia with no obstructive CAD or angina with no obstructive CAD (INOCA/ANOCA). In the oIHD group, men prevailed (67.5%) while in the INOCA/ANOCA group, women prevailed (57.5%). Noninvasive PPG evaluation of the vasculature was performed, and WNT1, -3a, -4, and -5a concentrations were measured by ELISA in all patients.Results Higher concentrations of the WNT1 and WNT3a proteins were found in patients with oIHD (p&lt;0.001) while the INOCA/ANOCA group had a significantly higher concentration of WNT5a (p=0.001). According to the PPG data, the arterial stiffness index (aSI) significantly differed between the INOCA/ANOCA (7.6 m/s [6.6; 9.35]) and oIHD (9.25 m/s [7.88; 10.33]) groups, p=0.048). The correlation analysis revealed a relationship between WNT1 and the reflectance index RI (ρ=0.359; p=0.014) in IHD patients (oIHD+INOCA/ANOCA). According to the ROC analysis, the curve for WNT3a turned out to be diagnostically significant (sensitivity and specificity of the model were 85.7 and 87.0%, respectively). The cut-off value of WNT3a was 0.183 pg/ml.Conclusion      The results of the study showed that the activation of the canonical WNT cascade (WNT1 and WNT3a) was observed in patients with oIHD, while the non-canonical cascade (WNT5a) was activated in patients with INOCA/ANOCA. The obstructive IHD phenotype can be predicted with a WNT3a value ≥0.183 pg/ml.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"65 3","pages":"3-9"},"PeriodicalIF":0.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804878","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":"Molecular Biological Methods in The Etiological Diagnostics of Infective Endocarditis.","authors":"E O Kotova, Zh D Kobalava, A S Pisaryuk, A Yu Moiseeva, E A Domonova","doi":"10.18087/cardio.2025.3.n2869","DOIUrl":"10.18087/cardio.2025.3.n2869","url":null,"abstract":"<p><p>Aim      To study the role of early blood tests using the polymerase chain reaction (PCR) (before or at initial stages of antibacterial therapy, within the first 24-48 hours after diagnosis) for the diagnosis of infective endocarditis (IE) and improvement of the etiological algorithm.Material and methods  The study included 154 patients with confirmed IE (DUKE, 2015) who underwent standard microbiological (culture) blood tests with a simultaneous molecular biological test (PCR study/sequencing) on the same type of biological material at the stage of primary diagnosis.Results In 117 (76.0%) examined patients, the etiologic agent was determined in blood samples by any of the methods used. Concordant results were obtained in 43 (36.8%) patients and discordant in 4 (3.4%) patients. In 29 (24.8%) patients, the causative agent of IE was determined only by the microbiological (cultural) examination of blood samples, and in 25 (21.4%) patients, only by the PCR study, including 3 cases of Bartonella spр. 23 patients had results of the microbiological (culture) blood tests that required clarification (70% CoNS, 26% gram-negative bacteria, one case of Enterococcus faecalis); 16 (69.6%) of 23 were not confirmed by the molecular biological method and were interpreted as contamination. In 1/3 of patients, the PCR blood study allowed increasing the accuracy of determining the causative agent of IE. Based on the integrated approach to the etiological diagnosis of IE, criteria for determining the causative pathogen were developed. This allowed reclassifying 9 (5.9%) diagnoses into the category of confirmed IE and to de-escalate the antibacterial therapy in every third examined patient. The microbiological and PCR studies of blood demonstrated comparable indexes of sensitivity, specificity and diagnostic accuracy [79.0, 86.0, 81.0% and 67.0, 93.0, 74.0%, respectively]. The PCR study of blood at the early stages of IE diagnosis (before or during the initial antibacterial therapy, within the first 24-48 hours after the IE diagnosis) is proposed as a control for Streptococcus spp., Staphylococcus aureus, CoNS, Enterococcus spр., and at the later stages of laboratory examination, especially in IE with an unspecified pathogen, as a priority method.Conclusion      The PCR study of blood samples is a highly informative method for the etiological diagnosis of IE that allows increasing the accuracy of the pathogen identification in every third patient and, thus, prescribing an effective antibacterial therapy.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"65 3","pages":"10-20"},"PeriodicalIF":0.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804874","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":"[Abstracts of the National Congress with international participation \"Heart Failure 2024\". Moscow, 07.12.2024 - 09.12.2024].","authors":"Article Editorial","doi":"10.18087/cardio.2025.3.n2912","DOIUrl":"10.18087/cardio.2025.3.n2912","url":null,"abstract":"<p><p>Abstracts of the National Congress with international participation \"Heart Failure 2024\". Moscow, 07.12.2024 - 09.12.2024.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"65 3","pages":"48-92"},"PeriodicalIF":0.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804871","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":"Multifactorial Prediction of the Risk of Hospital Mortality in Patients With Acute Coronary Syndrome.","authors":"E S Korotaeva, A D Zajtzev, L Yu Koroleva, I V Fomin, V N Nosov, G V Kovaleva","doi":"10.18087/cardio.2025.2.n2788","DOIUrl":"10.18087/cardio.2025.2.n2788","url":null,"abstract":"<p><p>Aim      To identify predictors for the risk of in-hospital death and to develop a prognostic scale for individual risk of death in patients with acute coronary syndrome (ACS) at the hospital stage of treatment.Material and methods  A sequential retrospective analysis was conducted, including 225 patients with ACS (n=101, main group of patients who died in hospital; n=124, control group) hospitalized in the Regional Vascular Center #2 of the Semashko Nizhny Novgorod Regional Clinical Hospital from January, 2021 through July, 2022. Clinical, demographic, laboratory and instrumental characteristics of patients were studied. Statistical analysis was performed using the Statistica version 10.0 and MedCalc version 20.0 software. The cutoff threshold for quantitative variables was determined by ROC analysis. Potential outcome predictors were identified by a univariate logical regression analysis followed by the construction of a multivariate model for predicting in-hospital mortality using the stepwise analysis with backward inclusion. The prognostic degree of a predictor was expressed as an odds ratio (OR) with a 95% confidence interval (CI). Differences were considered statistically significant at p&lt;0.05. For each variable of the multivariate regression model, an individual score was calculated using a linear transformation of the beta coefficients of each variable.Results Seven independent predictors of hospital death were identified in patients with ACS: Killip class II or higher acute heart failure (AHF) (OR 5.96; 95% CI 1.82-19.48; p=0.0031), low hemoglobin ≤127 g/l (OR 3.75; 95% CI 1.39-10.07; p=0.0087), elevated blood glucose on admission ≥9.7 mmol/l (OR 4.86; 95% CI 1.55-15.21; p=0.0065), high body mass index (BMI) ≥32 kg/m2 (OR 7.18; 95% CI 2.65-19.42; p=0.0001), high pulmonary artery systolic pressure (PASP) ≥38 mmHg (OR 3.95; 95% CI 1.48-10.51; p=0.0059), reduced left ventricular ejection fraction (LVEF) according to Simpson (%) ≤42% (OR 5.80; 95% CI 2.15-15.68; p=0.0005), reduced glomerular filtration rate (GFR) according to CKD-EPI ≤55 ml/min (OR 5.75; 95% CI 2.16-15.28; p=0.0005). An individual score was calculated for each predictor. The total score of all predictors formed a scale that was ranged from score 0 to 43 with a cutoff threshold of 14, where a result &gt;14 indicated a high probability of in-hospital death. This scale has a high prognostic potential with the sensitivity 93.07%, specificity 86.29%, and the area under the curve (AUC) 0.957.Conclusion      Based on the obtained multifactorial model that included 7 major predictors, a scale (scoring system) was developed for predicting the risk of death for ACS patients at the hospital stage of treatment. This scale allows fast identification of patients with a high risk of in-hospital death with a high prognostic accuracy in real clinical practice.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"65 2","pages":"17-25"},"PeriodicalIF":0.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588215","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":"[Effectiveness Analysis of The I NEED HELP Scale For Prognostic Evaluation of Heart Transplant Waiting List Patients].","authors":"V A Znamensky, K V Chelnyntsev, M A Lisovsky, E A Lyasnikova, M Yu Sitnikova, P A Fedotov","doi":"10.18087/cardio.2025.2.n2830","DOIUrl":"10.18087/cardio.2025.2.n2830","url":null,"abstract":"<p><p>Aim    To evaluate the efficacy of the I NEED HELP scale in determining the six-month prognosis for patients on the heart transplant waiting list (HTWL) of the Almazov National Medical Research Center of the Russian Ministry of Health.Material and methods    This retrospective study included 42 patients from the HTWL. The patients' survival for more than 6 months was assessed. The composite end point (CEP) of adverse outcome was all-cause death, heart transplantation (HT) due to the increased urgency of surgical intervention according to UNOS within 6 months after the inclusion in the HTWL. Patients were evaluated using the I NEED HELP scale. Statistical analysis was performed by nonparametric methods.Results    The median I NEED HELP score was 4 [from 1 to 7]. The increase in score was positively correlated with the incidence of adverse outcomes (r=0.5; p=0.0007). The group of patients with an unfavorable outcome had a median score higher by one than for the survivors (score 5 vs. 4, respectively; p=0.001). The greatest effect on the prognosis was exerted by low systolic blood pressure (SBP) (p=0.003); the failure to increase or the necessity to decrease the doses of disease-modifying drugs (p=0.039); and target organ dysfunction (p=0.039). The sensitivity and specificity of the scale at a score 5 or higher were 100% and 84%, respectively.Conclusion    This pilot study demonstrated the efficacy of the I NEED HELP scale in a patient population from a specialized center HTWL with high sensitivity and specificity at the determined threshold score 5 for an unfavorable outcome. It is appropriate to continue the study with an expanded sample and validation of the scale on patient cohorts from hospitals of various healthcare system levels.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"65 2","pages":"64-68"},"PeriodicalIF":0.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Artificial Intelligence in Cardiology.","authors":"Yu N Belenkov, M V Kozhevnikova, N V Khabarova, I S Ilgisonis, E O Korobkova","doi":"10.18087/cardio.2025.2.n2879","DOIUrl":"10.18087/cardio.2025.2.n2879","url":null,"abstract":"<p><p>Artificial intelligence (AI) has an enormous potential for improving the quality of medical care, diagnostic methods, and treatments. AI allows taking scientific research to a fundamentally new level. The article addresses the most important areas of using AI in cardiology. AI can be used to accelerate making clinical decisions, remote patient monitoring, tomographic image analysis, patient phenotyping, including metabolomic analysis, to assess the risk of complications and many other areas.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"65 2","pages":"3-16"},"PeriodicalIF":0.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588224","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":"Individualized Nutritional Support Improves Cardiac Function and Nutritional Status of Elderly Heart Failure Patients.","authors":"Hang Chen, Ping Xu, Jia Hu, Hong Li, Yuan Yan, Yu Cai","doi":"10.18087/cardio.2025.2.n2764","DOIUrl":"10.18087/cardio.2025.2.n2764","url":null,"abstract":"<p><p>Background    The quality of life of the patient is diminished by chronic heart failure (CHF), which also costs the healthcare system. This study examined the benefits of individualized nutritional support provided by a specialized nursing team on the nutritional status and cardiac function of elderly patients with CHF.Material and methods    This study included 102 elderly, hospitalized CHF patients. The patients were randomly assigned to two groups of 51 each. During the study protocol, the control group received regular nursing care, while the experimental group received individualized nutritional support by a specialized nursing team. Nutritional-related and cardiac function indicators, inflammatory factors, and life quality scores measured before and after the protocol were compared.Results    There was a significant increase in total albumin, hemoglobin, and protein in both groups during the protocol, but the final concentrations were significantly higher in the experimental group (p&lt;0.05). In both groups, the left ventricular ejection fraction was increased after the protocol, while the left ventricular end-systolic dimension and the left ventricular end-diastolic dimension significantly decreased. The improvements in these variables were greater in the experimental group (p&lt;0.05). The experimental group also exhibited significantly reduced tumor necrosis factor-α, interleukin-6, and high sensitivity C-reactive protein (p&lt;0.05), and the experimental group reported higher quality of life (p&lt;0.05) and nursing satisfaction (p&lt;0.05).Conclusion    Nutritional support of elderly CHF patients administered by a specialized nursing team improved nutrition, cardiac function, inflammatory status, and quality of life compared to standard nutrition and regular nursing care.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"65 2","pages":"48-56"},"PeriodicalIF":0.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588213","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":"Prognostic Factors in Moderate-to-Large Pericardial Effusion Requiring Pericardiocentesis. A Single-Center Retrospective Study.","authors":"Sevil Gülaştı, Berk Mutlu, Cemil Zencir","doi":"10.18087/cardio.2025.2.n2324","DOIUrl":"10.18087/cardio.2025.2.n2324","url":null,"abstract":"<p><p>Aim    Pericardial effusion is relatively common in daily clinical practice. To our knowledge, no study to date has been conducted on any laboratory parameter that predicts mortality in patients presenting with pericardial effusion. The present study evaluated the prognostic factors of patients with moderate to large pericardial effusions requiring pericardiocentesis.Material and methods    This retrospective study included 156 patients who underwent pericardiocentesis in our hospital between 2013 and 2022.Results    73 of the patients (46.8 %) survived. Nonsurvivors had hypoalbuminemia more often than survivors (p&lt;0.001). Median follow-up time in non-survivors was 274.5 [4.0-3507.0] days, while median follow-up time in survivors was 1490.0 [109.0-3209.0]. In-hospital mortality was seen in only 8 patients. The median neutrophil / lymphocyte ratio was significantly lower in survivors than nonsurvivors (p=0.005). The ROC curve analysis showed that the neutrophil / lymphocyte ratio was higher than 4.49, with sensitivity and specificity rates of 78.57 % and 51.75 % in predicting mortality (AUC=0.622, 95 % confidence interval: 0.541-0.698, p=0.013).Conclusions    The present study showed that the neutrophil / lymphocyte ratio and hypoalbuminemia, which are laboratory values at the time of admission, albumin in the pericardial fluid, and malignant pathology all play roles in the prognosis of pericardial effusion requiring pericardiocentesis.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"65 2","pages":"42-47"},"PeriodicalIF":0.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588217","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":"Tumor Necrosis Factor-α, Vascular Endothelial Growth Factor and miRNA-145 Expression in Patients With Different Phenotypes of Stable Coronary Artery Disease.","authors":"A O Yusupova, O A Slepova, N N Pakhtusov, M I Kalinina, E V Privalova, Yu N Belenkov","doi":"10.18087/cardio.2025.2.n2837","DOIUrl":"10.18087/cardio.2025.2.n2837","url":null,"abstract":"<p><p>Aim      To evaluate the expression level of miR-145, tumor necrosis factor α (TNF-α), and vascular endothelial growth factor (VEGF) in patients with ischemic heart disease (IHD) and different, obstructive and non-obstructive, phenotypes of coronary artery disease (CAD).Material and methods  This cross-sectional observational study included 107 patients aged 45-75 years with a verified diagnosis of stable IHD. Based on the data of coronary angiography or spiral multislice computed tomography of CA, the patients were divided into two groups, with no obstructive (NOCA, 51 patients) and with obstructive coronary artery (OCA, 56 patients). In the NOCA group, women predominated (62.5%), while among patients with OCA, men predominated (67.9%). Concentrations of VEGF and TNF-α and miRNA-145 expression were measured in patients of both groups.Results In the NOCA group, the concentrations of VEGF (p=0.004) and TNF-α (p=0.002) and the miRNA-145 expression (p=0.014) were significantly higher. In this group, the miRNA-145 concentration was correlated with the concentrations of VEGF (ρ=0.442; p=0.013) and TNF-α (ρ=-0.386; p=0.032). In the OCA group, correlations were found between the concentrations of TNF-α and VEGF (ρ=0.645; p&lt;0.001), miRNA-145 and VEGF (ρ=0.584; p&lt;0.001), and miRNA-145c and TNF-α (ρ=0.421; p&lt;0.001). According to the univariate logistic regression analysis, significant factors for the CAD type were miRNA-145 expression and female gender. A statistically significant ROC curve was constructed to evaluate the diagnostic capability of miRNA-145.Conclusion      According to the study results, the highest level of miRNA-145 expression was found in the NOCA group. The ROC analysis showed that a level of miRNA-145 expression higher than 1.084 REU can be a factor of the NOCA phenotype presence in patients with stable IHD. A lower level of miRNA-145 expression can be associated with more severe atherosclerotic CAD.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"65 2","pages":"26-33"},"PeriodicalIF":0.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588226","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":"[Transthyretin Amyloid Cardiomyopathy as the Cause of Aortic Stenosis].","authors":"M V Ezhikova, S N Nasonova, I V Zhirov, A A Shoshina, O Ya Tchaikovskaya, S V Dobrovolskaya, A A Ansheles, M A Saidova, S N Tereshchenko","doi":"10.18087/cardio.2025.2.n2849","DOIUrl":"10.18087/cardio.2025.2.n2849","url":null,"abstract":"<p><p>Currently, the diagnosis of amyloid cardiomyopathy (ACM) causes great difficulties both for practicing primary care physicians and specialists. One of the reasons is the variety of symptoms in patients with ACM. The most common ACM manifestations include heart failure with preserved left ventricular ejection fraction, hypertrophic phenotype of cardiomyopathy, thromboembolic complications, and valvular apparatus damage. Common valvular manifestations are mitral and tricuspid valve insufficiency and aortic stenosis (AS). Diagnosis is particularly difficult in patients with AS requiring differentiation between AS as a degenerative defect and AS of amyloid origin. According to the literature, in 4-16% of cases of older patients (≥65 years), the genesis of AS is precisely the amyloid damage.</p>","PeriodicalId":54750,"journal":{"name":"Kardiologiya","volume":"65 2","pages":"69-76"},"PeriodicalIF":0.5,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588211","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}