Journal of Rehabilitation Medicine最新文献

{"title":"Immersive visualization of movement in patients with hemophilic ankle arthropathy. Multicenter, single-blind, randomized clinical trial.","authors":"Roberto Ucero-Lozano, Raúl Pérez-Llanes, Rubén Cuesta-Barriuso, Elena Donoso-Úbeda","doi":"10.2340/jrm.v56.40775","DOIUrl":"10.2340/jrm.v56.40775","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of immersive movement observation in adult patients with haemophilic ankle arthropathy.</p><p><strong>Design: </strong>Multicentre, single-blind, randomized clinical trial.</p><p><strong>Subjects: </strong>48 patients with haemophilia.</p><p><strong>Methods: </strong>Patients were randomly allocated to 2 groups (180º immersive video-based visualization of movement and a control group with no intervention). Twenty-eight consecutive 15-min home sessions, 1 per day, of immersive visualization of ankle flexion-extension movement were carried out. Three evaluations were performed: pretreatment (T0), post-intervention (T1), and at 16 weeks' follow-up (T2). The primary variable was joint-pain intensity (visual analogue scale). The secondary variables were conditioned pain modulation (Conditioned Pain Modulation Index), pressure pain threshold (pressure algometer), range of motion (goniometry) and kinesiophobia (Tampa Scale of Kinesiophophia).</p><p><strong>Results: </strong>There were intergroup differences in pain intensity (F = 37.14; p < 0.001), conditioned pain modulation (F = 5.40; p = 0.006), and dorsal (F = 19.17; p < 0.001) and plantar (F = 9.27; p<0.001) ankle flexion. More than 50% of experimental group patients exhibited changes exceeding the minimum detectable change in pain intensity (MDC = 0.43), and the pressure pain threshold in the extensor carpi radialis longus muscle (MDC = 1.34) and malleolus (MDC = 4.93).</p><p><strong>Conclusions: </strong>180º immersive video-based visualization of movement can improve the intensity of pain, conditioned pain modulation, and ankle range of motion in patients with haemophilic ankle arthropathy.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"56 ","pages":"jrm40775"},"PeriodicalIF":2.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The veracity function: integrity, and comprehensiveness of evidence.","authors":"Antti Malmivaara","doi":"10.2340/jrm.v56.40350","DOIUrl":"10.2340/jrm.v56.40350","url":null,"abstract":"","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"56 ","pages":"jrm40350"},"PeriodicalIF":2.5,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11458917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a new video observational training method (intensive visual simulation) for motor recovery in the upper limb in subacute stroke: a feasibility and proof-of-concept study.","authors":"Etienne Ojardias, Ahmed Adham, Hugo Bessaguet, Virginie Phaner, Diana Rimaud, Pascal Giraux","doi":"10.2340/jrm.v56.36119","DOIUrl":"10.2340/jrm.v56.36119","url":null,"abstract":"<p><strong>Objective: </strong>To demonstrate the feasibility and efficacy  of a new video-observation training method (intensive visual simulation) to improve upper limb function.</p><p><strong>Design: </strong>Small sample, randomized, evaluator-blind, monocentric study.</p><p><strong>Patients: </strong>Seventeen early subacute ischaemic stroke patients with complete hemiplegia were  randomly assigned to the therapeutic group (n = 8) or control group (CG, n = 9).</p><p><strong>Methods: </strong>Thirty sessions of intensive visual simulation combined with corrected visual feedback (therapeutic group) or uncorrected visual feedback (control group) were performed over 6 weeks on top of a standard rehabilitation programme.</p><p><strong>Main outcome measure: </strong>400-point hand assessment test (400p-HA).</p><p><strong>Secondary outcome measures: </strong>Box and Blocks (B&B), Purdue Pegboard test, Minnesota.</p><p><strong>Results: </strong>The 400p-HA test improved significantly from T0 to 6 months for both groups, with a significant difference between groups at 3 months (MW-UT p = 0.046) and 4 months (MW-UT p = 0.046) in favour of the therapeutic group. One-phase exponential modelling of 400p-HA showed a greater plateau for the therapeutic group (F test p = 0.0021). There was also faster recovery of the ability to perform the B&B tests for the therapeutic group (log-rank test p = 0.03).</p><p><strong>Conclusion: </strong>This study demonstrated the feasibility and potential efficacy of an intensive visual simulation training programme to improve upper limb  function in subacute stroke patients. A larger study is needed to confirm these results.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"56 ","pages":"jrm36119"},"PeriodicalIF":2.5,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11445588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of mirror therapy in post-traumatic complex regional pain syndrome type-1: a randomized controlled study.","authors":"Elif Can Özdemir, Atilla H Elhan, Ayşe A Küçükdeveci","doi":"10.2340/jrm.v56.40417","DOIUrl":"10.2340/jrm.v56.40417","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of mirror therapy applied in addition to routine rehabilitation on clinical outcomes in post-traumatic complex regional pain syndrome type 1.</p><p><strong>Design: </strong>Single-blind randomized controlled trial.</p><p><strong>Subjects: </strong>Patients with trauma-induced complex regional pain syndrome type 1 of the hand receiving outpatient rehabilitation.</p><p><strong>Methods: </strong>Patients were randomized into mirror therapy and control groups. All patients received routine physical therapy and rehabilitation for 20 sessions (5 sessions/week, for 4 weeks). The mirror group received additional mirror therapy at each session. The primary outcome was pain intensity by numeric rating scale. Secondary outcomes were grip/pinch strength, hand/wrist circumference, dexterity, hand activities, and health-related quality of life. All assessments were performed before and immediately after the treatment, and 4 weeks later at follow-up.</p><p><strong>Results: </strong>Forty patients were enrolled, 20 in each group. Both groups revealed statistically significant improvements from therapy regarding pain, grip/pinch strength, wrist circumference, dexterity, and hand activities (p <  0.05). When groups were compared regarding the improvements in assessment parameters, no statistically significant difference was found between the 2 groups in any of the outcomes (p > 0.05).</p><p><strong>Conclusion: </strong>Mirror therapy applied in addition to routine therapy in post-traumatic complex regional pain syndrome type 1 did not provide extra benefit to the improvement of pain, function, and other clinical outcomes.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"56 ","pages":"jrm40417"},"PeriodicalIF":2.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing upper extremity muscle strength in individuals with spinal cord injury using low-intensity blood flow restriction exercise.","authors":"Babak Shadgan, Mehdi Nourizadeh, Yekta Saremi, Leila Baktash, Stefan Lazarevic","doi":"10.2340/jrm.v56.40608","DOIUrl":"10.2340/jrm.v56.40608","url":null,"abstract":"<p><strong>Objectives: </strong>This study explores the feasibility and effects of low-intensity blood flow restriction exercise on forearm muscle strength and function in individuals with spinal cord injury.</p><p><strong>Study design: </strong>Pilot randomized clinical trial.</p><p><strong>Patients and methods: </strong>Ten male and female adult participants with chronic cervical and thoracic spinal cord injury underwent an 8-week low-intensity blood flow restriction exercise programme that targeted forearm muscles. Each participant's contralateral forearm served as the control. Grip strength was the primary outcome measure, and participants also provided qualitative feedback on their experiences.</p><p><strong>Results: </strong>The study revealed a significant increase in participants' forearm muscle strength on the experimental side engaged in low-intensity blood flow restriction training, with an average strength gain of 7.5 ± 0.36 kg after 16 exercise sessions (Cohen's d = -6.32, 95% CI -8.34, -6.68). In comparison, the control side, following a conventional high- intensity exercise regimen without BFR, showed a more modest strength increase of 4.4 ± 0.67 kg. A mean Patient's Global Impression of Change score of 2.2 reflected overall improvements in participants' daily activities and health status.</p><p><strong>Conclusion: </strong>This study highlights the feasibility and effectiveness of low-intensity blood flow restriction exercise as a safe and promising approach to enhancing forearm muscle strength in individuals with spinal cord injury. The observed positive outcomes, coupled with a high level of participant satisfaction, underscore the potential of this innovative method to significantly improve limb muscle strength, thereby contributing to greater functional independence in this population.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"56 ","pages":"jrm40608"},"PeriodicalIF":2.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease and obstructive sleep apnea; a randomized controlled trial.","authors":"Honghua Shen, Yiming Xu, Yin Zhang, Lei Ren, Rui Chen","doi":"10.2340/jrm.v56.23757","DOIUrl":"10.2340/jrm.v56.23757","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of pulmonary rehabilitation in the outcomes of patients with chronic obstructive pulmonary disease-obstructive sleep apnoea overlap syndrome patients who used positive airway pressure.</p><p><strong>Design: </strong>Prospective randomized controlled single- blind trial.</p><p><strong>Patients: </strong>A total of 79 patients with chronic obstructive pulmonary disease-obstructive sleep apnoea overlap syndrome were randomly assigned to either the intervention group (n = 40) or control group (n = 39).</p><p><strong>Methods: </strong>All patients consistently adhered to positive airway pressure therapy every night from enrolment in the study, while intervention group patients received additional moderate-intensity aerobic exercise for 20 weeks. Pre- and post-intervention measurements included the 6-Minute Walk Test, Barthel Index, body mass index, fat mass, free fat mass, forced expiratory volume in 1 s (FEV1), FEV1%predicted, modified Medical Research Council, and polysomnography parameters.</p><p><strong>Results: </strong>After 20 weeks, the intervention group exhibited statistically significant improvements in 6MWD, Barthel Index, body mass index, fat mass, and modified Medical Research Council compared with control group (all p < 0.01). In addition, the intervention group showed a significantly lower percentage of total sleep time with oxygen saturation < 90% (p = 0.013) and higher lowest nocturnal oxygen saturation (p = 0.008) than the control group. However, there was no significant difference in FEV1 %predicted between the 2 groups.</p><p><strong>Conclusion: </strong>Pulmonary rehabilitation incorporating moderate-intensity aerobic exercise could improve physical endurance and motor abilities in individuals with chronic obstructive pulmonary disease-obstructive sleep apnoea overlap syndrome, while also improving anamnestic dyspnoea, body composition, and sleep-disordered breathing.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"56 ","pages":"jrm23757"},"PeriodicalIF":2.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-reported mental health in hospitalized patients with COVID-19: A 1-year follow-up.","authors":"Linda Ashman Kröönström, David Krabbe, Alexandra Larsson, Lena Rafsten, Annie Palstam, Katharina S Sunnerhagen, Hanna C Persson","doi":"10.2340/jrm.v56.40654","DOIUrl":"10.2340/jrm.v56.40654","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to longitudinally follow self-reported symptoms of depression, anxiety, post-traumatic stress disorder, and fatigue during the first year after hospitalization because of COVID-19.</p><p><strong>Design: </strong>The study was an observational longitudinal study.</p><p><strong>Methods and participants: </strong>Between July 2020, and February 2021, 211 patients aged ≥ 18 years, hospitalized ≥ 5 days at 5 hospitals in Region Västra Götaland, who had COVID-19, and were non-contagious (at study enrolment) were included in the baseline assessment. Of these, 168 (79.6%) patients completed mental health questionnaires at a 3-month follow-up, and 172 (83.1%) at a 12-month follow-up. A total of 120 (56.9%) participants who completed at least 1 questionnaire at both the 3- and 12-month follow-ups were analysed; the majority were male (n = 78, 65.0%).</p><p><strong>Results: </strong>There was an improvement in all patients from 3 to 12 months on the fatigue subscales \"reduced activity\" (p = 0.02) and \"physical fatigue\" (p = 0.04). No other significant mental health improvements were found. At 12 months, 34 (28.4%) were classified as having anxiety symptoms, 29 (24.1%) as having depression symptoms, and 40 (33.3%) had symptoms of probable post-traumatic stress disorder.</p><p><strong>Conclusions: </strong>Participants in the present study did not report full mental health recovery 1 year after hospitalization for COVID-19.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"56 ","pages":"jrm40654"},"PeriodicalIF":2.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-month functional training programme improves knee joint function in athletes post-ACL reconstruction surgery.","authors":"Chuanjia Du,Jiao Jiao,Jihe Zhou,Bik Chu Chow,Qiuqiong Shi,Xiaopei Zhang,Siyu Liu,Jianchao Yang","doi":"10.2340/jrm.v56.18701","DOIUrl":"https://doi.org/10.2340/jrm.v56.18701","url":null,"abstract":"OBJECTIVERehabilitation and recovery duration following anterior cruciate ligament reconstructive surgery play a pivotal role in restoring optimal knee functionality in athletes. This study aimed to explore the impact of a 3-month functional training programme aligned with enhanced recovery after surgery on recuperation subsequent to anterior cruciate ligament reconstructive surgery.DESIGNA quasi-experimental study.SUBJECTSA cohort of 34 patients aged 14 to 24, who underwent anterior cruciate ligament reconstructive surgery and adhered to enhanced recovery after surgery protocols during the perioperative period, were allocated to an experimental group and a control group according to their eligibility, capacity, and willingness to engage in the functional training programme.METHODSThe participants in the experimental group underwent a 3-month regimen of functional training following anterior cruciate ligament reconstructive surgery, whereas the control group followed a conventional recovery approach. Evaluations were conducted both prior to and following the 3-month recovery interval, utilizing the Y-Balance Test, Functional Movement Screening, and Isokinetic Knee Test.RESULTSAssessment outcomes of the Y-Balance Test, Isokinetic Knee Test, and Functional Movement Screening exhibited significant enhancement (p < 0.05) within the experimental group, as opposed to the control group. These findings underscore that those athletes who undertook the 3-month functional training regimen within the experimental group exhibited heightened dynamic balance capabilities, increased knee joint mobility, and enhanced stability compared with their counterparts in the control group.CONCLUSIONConsequently, this underscores the efficacy of the 3-month functional training protocol aligned with enhanced recovery after surgery, as a means to effectively facilitate recuperation subsequent to anterior cruciate ligament reconstructive surgery.","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"1 1","pages":"jrm18701"},"PeriodicalIF":3.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268023","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":"Efficacy of selective neurotomy for focal lower limb spasticity: a systematic review.","authors":"Danique J M Ploegmakers,Hanneke J R Van Duijnhoven,Liron S Duraku,Erkan Kurt,Alexander C H Geurts,Tim De Jong","doi":"10.2340/jrm.v56.39947","DOIUrl":"https://doi.org/10.2340/jrm.v56.39947","url":null,"abstract":"OBJECTIVESelective neurotomy has been suggested as a permanent treatment for focal spasticity. A systematic literature review was performed to investigate the efficacy of selective neurotomy regarding focal lower limb spasticity.METHODSA systematic search in PubMed, Medline, Cochrane, and Embase databases was carried out. Studies were included if they reported on the following outcomes: muscle tone, muscle strength, pain, ankle range of motion and/or walking speed, after selective lower limb neurotomy in any type of upper motor neuron syndrome.RESULTSA total of 25 non-randomized and/or uncontrolled studies and 1 randomized controlled study were selected. The included studies reported improvements in terms of leg muscle tone, pain, passive range of ankle motion, and walking speed.CONCLUSIONThe results suggest that selective neurotomy is effective for reducing lower limb spasticity, without any negative effects on walking speed. However, this conclusion is primarily based on uncontrolled case series, whereas conclusions on clinical efficacy should preferably be based on comparison with a reference treatment through (randomized) controlled trials. Future studies should also include quantitative, validated functional assessment tools to further establish the efficacy of selective neurotomy as long-lasting treatment for patients with focal lower limb spasticity.","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"20 1","pages":"jrm39947"},"PeriodicalIF":3.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142176135","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":"Heart rate variability activity in soccer athletes after a musculoskeletal injury.","authors":"Gonçalo Flores,Diogo Monteiro,Fernanda Silva,Pedro Duarte-Mendes","doi":"10.2340/jrm.v56.24969","DOIUrl":"https://doi.org/10.2340/jrm.v56.24969","url":null,"abstract":"OBJECTIVESThe aim of this study is to analyse the adaptations of the autonomic nervous system after a musculoskeletal injury, obtained by measuring heart rate variability in athletes. It was hypothesized that there is an alteration in heart rate variability after a musculoskeletal injury.STUDY DESIGNCohort study.SUBJECTS15 semi-professional soccer players from three football teams, aged between 21 and 33 (mean age: 29.4 ± 3.31 years), with a recent musculoskeletal injury.METHODSHeart rate variability was collected using the Polar m200 and the chest strap H10 in two moments: within 72 h after the injury and between 5 and 7 days after full return-to-play.RESULTSResults show differences between T1 and T2 (p ≤ 0.05) in low-frequency power (n.u.) (p = 0.001) and high-frequency power (n.u.) (p = 0.001), in low-frequency/high-frequency ratio (p = 0.001) and in high-frequency power (ms2) (p = 0.017) measures. No statistical differences were found in low-frequency power (ms2) (p = 0.233). The low frequency power (n.u.) was significantly lower after injury compared with LF power (n.u.) values after full return-to-play. In high-frequency power there was a significant difference between both moments with high values after injury.CONCLUSIONSThe use of heart rate variability therefore seems to be promising to detect an imbalance in the autonomic nervous system and help clinical departments to identify a possible non-traumatic musculoskeletal injury. Further research should be performed considering a wide range of musculoskeletal injuries and to establish baseline values of the athletes.","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"9 1","pages":"jrm24969"},"PeriodicalIF":3.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142176134","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}