Journal of Cranio-Maxillofacial Surgery最新文献

{"title":"Preliminary quantitative assessment of surgical outcomes in Craniosynostosis correction procedures: A 3D-Morphometric comparison.","authors":"Urbano Urbani, Luca Borro, Alessia Giorgi, Sergio Silvestri, Marta Cecchitelli, Olivia Pagliarosi, Jan Galo, Luca Armisi, Mario Zama, Aurelio Secinaro","doi":"10.1016/j.jcms.2025.03.012","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.03.012","url":null,"abstract":"<p><p>Craniosynostosis (or Craniostenosis) is a premature pathological fusion of cranial sutures that leads to skull deformities and potential neurological complications. This study focuses on a common non-syndromic form and aims to quantitatively assess surgical outcomes immediately after corrective procedures. The purpose is to present a technique for morphometric analysis in patients with sagittal synostosis. Several surgical techniques can be adopted for this condition, and their effectiveness depends on the severity and age of the patient. Morphometric indices, such as the Cephalic Index (CI), Intracranial Volume (ICV), Frontal Sagittal Index (FSI), and Occipital Sagittal Index (OSI), are commonly used for evaluation. Midsagittal Vector Analysis (MSVA) and volumetric approaches have been applied to assess cranial morphology. However, most studies focus on long-term outcomes, comparing affected children to healthy peers. In this work, 3D reconstructions obtained from computed tomography (CT) scans, taken before and after surgery, are analyzed using an innovative implementation of the MSVA method and a volumetric approach to assess immediate corrective actions quantitatively. The study was conducted on 12 patients, collaborating with the Biomedical 3D-Printing Laboratory and the Craniofacial Surgery Unit at Bambino Gesù Children's Hospital in Rome. The surgical technique implies craniotomy, bone removal, frontal incisions, and cranial vault remodelling to normalize skull shape and intracranial volume. These vectorial and volumetric analyses allow for a more precise evaluation of immediate surgical outcomes and provide valuable insights for optimizing surgical procedures for this cranial condition.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812938","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":"Compare the accuracy and performance of two different types of CAD-CAM surgical guides for maxillary positioning in orthognathic surgery.","authors":"Douglas Voss de Oliveira, Nayara Cristina Monteiro Carneiro, Júlia Ferreira Folhes, José Thiers Carneiro Júnior","doi":"10.1016/j.jcms.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.03.011","url":null,"abstract":"<p><p>Three-dimensional computer-aided design/manufacturing (CAD/CAM) maxillary guides have been developed to enhance surgical predictability, reducing mandibular interference and improving planning accuracy, especially in asymmetrical cases. This study aimed to compare the accuracy of two types of CAD/CAM guides used for maxillary positioning in orthognathic surgery. In this retrospective cohort study, 38 patients who underwent bimaxillary orthognathic surgery by the same surgeon were divided into two groups. Group 1 (n = 21) used a tooth-bone-supported guide with dual functionality for maxillary positioning and osteotomy. Group 2 (n = 17) used a bone-supported guide combined with pre-modeled titanium miniplates for osteotomy and drilling. Four fixed anatomical points (one bone and three dental) were marked preoperatively and postoperatively to assess 3D maxillary movement along the mediolateral (X), anteroposterior (Y), and vertical (Z) axes. The primary outcome was the precision of maxillary positioning, assessed by overlapping preoperative virtual planning and postoperative cone-beam computed tomography (CT) images. Quantitative differences in millimeters between the planned and achieved positions were measured for all points and axes. The groups were compared using Student's t-test (p < 0.05). Results showed that both groups achieved mean discrepancies of less than 1 mm across all points and axes. No significant differences in accuracy were observed between the two systems (p > 0.05). These findings suggest that both CAD/CAM guide systems provide high precision in maxillary positioning, offering reliable options for orthognathic surgeries based on surgeon preference.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789350","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":"Immersive reality surgical training for Le Fort I orthognathic surgery: Initial results of a randomized feasibility study.","authors":"Carolina Stevanie, Yossy Yoanita Ariestiana, Muh Anshar, Cortino Sukotjo, Paolo Boffano, Tymour Forouzanfar, Sri Hastuti Kurniawan, Muhammad Ruslin","doi":"10.1016/j.jcms.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.03.014","url":null,"abstract":"<p><p>Immersive reality (IR) technology has been shown to have benefits for surgical training, planning, and navigation of orthognathic surgery. This study evaluates the use of IR technology for training in Le Fort I (LFI) orthognathic surgery. Twelve participants, including surgery experts, IR specialists, engineering students, and residents, completed a simulation session and assessed the IR system's validity, reliability, and suitability. Participants noted the high realism of the images and the procedure's similarity to real surgery, without significant side effects. The IR system shows potential as an effective educational tool for orthognathic surgery, particularly for residents, and may compliment the traditional training methods.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797173","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":"Facial trauma management: A nationwide data collection on practice patterns and patient care in oral and maxillofacial surgery in Germany.","authors":"Philipp Becker, Frederic Bouffleur, Diana Heimes, Daniel G E Thiem, Lukas B Seifert, Andreas Neff, Jörg Wiltfang, Max Heiland, Marco Kesting, Anne-Kathrin Bär, Alexander-N Zeller, Andreas Pabst","doi":"10.1016/j.jcms.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.03.013","url":null,"abstract":"<p><p>This study aims to analyze facial trauma management, practice patterns, and patient care in Oral and Maxillofacial Surgery (OMFS) in Germany by using a dynamic online questionnaire with up to 54 questions. The survey, comprising single/multiple-choice and open-ended questions, was implemented via SurveyMonkey® and distributed to OMFS departments and surgeons in Germany. Data was analyzed anonymously and descriptively. Eighty-four OMFS departments and surgeons participated, revealing diverse facial trauma management. Monthly facial trauma patient volumes ranged from 0 to 10 (37.8 %) to more than 75 (4.88 %). Computed tomography (CT) was the primary imaging modality (82.05 %), supplemented by cone-beam CT and panoramic radiographs (56.41 % each). Orbital floor reconstruction primarily involved transconjunctival access (42.86 %) and prefabricated titanium meshes (69.01 %). Champy mini-plate osteosynthesis mainly managed mandibular angle fractures (51.47 %). Variability persists in the management of mandibular condylar process fractures in Germany. While a significant number of participants favor conservative treatment for condylar process fractures overall (26.87 %), the rate of surgical intervention for condylar head fractures is notably higher than international standards (59.42 %). Endoscopic techniques were rare (18.84 %). The management of standard thrombosis prophylaxis and perioperative antibiotic administration varied. Differences in specific facial trauma management were identified and assumed to be based on internal experiences and structural and personnel resources.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775002","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":"Comparisons between partial and total sialoadenectomy for benign submandibular gland tumors: A systematic review and meta-analysis.","authors":"Ke Dou, Tiantian Zhang, Baoyi Yang, Zhiguo Zhao","doi":"10.1016/j.jcms.2025.03.017","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.03.017","url":null,"abstract":"<p><p>This study aimed to compare postoperative efficacy and functional outcomes between partial sialoadenectomy (PS) and total sialoadenectomy (TS) in patients with benign submandibular gland (SMG) tumors. We systematically searched PubMed, Web of Science, EmBase, Cochrane Library, China Biomedical Literature, and CNKI from inception to 2024, following PICOS criteria (Population: Adults with benign SMG tumors; Intervention: PS; Comparison: TS; Outcomes: Salivary function, neurological complications, recurrence, operative duration, dry mouth, infection/hematoma; Study design: RCTs/observational studies with ≥ 6-month follow-up). The protocol was prospectively registered (PROSPERO CRD42024595824). Risk ratios (RR) were calculated for dichotomous outcomes, and weighted mean differences (WMD) for continuous outcomes, using random-effects models. Heterogeneity was quantified by I² statistics and Q tests. Sensitivity analyses included leave-one-out methods, and publication bias was assessed via funnel plots and Egger's test. The analysis of findings was guided by the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) framework to evaluate evidence certainty, while also considering the size of intervention effects in alignment with GRADE methodology. From 1014 screened studies, 7 studies (3 RCTs, 4 cohort studies) involving 399 patients (PS: n = 188; TS: n = 211) were included. PS demonstrated superior static saliva flow (WMD = 0.24, 95 %CI 0.13, 0.35)and reduced neurological complications (RR = 0.22, 95 %CI 0.10, 0.49), operative duration (WMD = -14.19, 95 %CI -23.4, -4.99), and dry mouth (RR = 0.12, 95 %CI 0.03, 0.49). However, there were no significant differences between the two groups in stimulated saliva flow (WMD = 0.01, 95 %CI -0.01, 0.04), tumor recurrence (RR = 3.23, 95 %CI 0.13, 77.99), postoperative infection (RR = 0.25, 95 %CI 0.03, 2.26), and postoperative hematoma (RR = 0.36, 95 %CI 0.08, 1.72). GRADE revealed moderate-certainty evidence for functional outcomesbut low/very low certainty for neurological complications, recurrence, operative duration, dry mouth, postoperative infection and hematoma. The current results demonstrate that partial sialoadenectomy offers significant advantages over traditional total sialoadenectomy.It is recommended that clinicians consider adopting new surgical procedures for the treatment of benign tumors of the submandibular gland in the future.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765984","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":"Retrospective evaluation of different designs of distraction osteogenesis in brachycephalic craniosynostosis.","authors":"Wooyeol Baek, Yun Jung Kim, Mijung Kim, Yong Oock Kim","doi":"10.1016/j.jcms.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.03.005","url":null,"abstract":"<p><p>This retrospective study analyzed the surgical outcomes of three different treatment design groups for craniosynostosis using distraction osteogenesis (DO). Thirty-six patients who underwent frontal bone advancement between 2009 and 2020 were divided into three groups based on the design and distraction method of the anterior frontal flap (AFF) and posterior flap (PF): Group 1 - Advancement of AFF; Group 2 - Simultaneous advancement of AFF and PF; Group 3 - Separate advancement of AFF and PF with a mid-coronal bridge (MCB). All surgical designs showed significant improvement in cranial shape, with increased anterior-posterior length and bitemporal length and decreased cephalic index (CI). Group 1 exhibited the worst bitemporal widening and CI improvement, while Group 2 and 3 were more effective in correcting brachycephaly. This study underscores the importance of surgical design in shape correction for bicoronal craniosynostosis, highlighting the benefits of addressing both the posterior occipital region and anterior forehead-orbital complex.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765986","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":"Understanding Re-operation in orthognathic surgery: A 17-year retrospective study analyzing causes and rates.","authors":"Emrah Soylu, Musab Süleyman Kılavuz, Cemil Eren, Ahmet Emin Demirbas, Yusuf Nuri Kaba, Nükhet Kütük, Erdem Kılıç, Osman A Etöz, Alper Alkan","doi":"10.1016/j.jcms.2025.03.010","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.03.010","url":null,"abstract":"<p><p>Orthognathic surgery is a standard procedure for correcting dentofacial deformities. While it generally yields satisfactory results, complications and re-operations can occur. The purpose of this study was to retrospectively analyze the reasons for the re-operation of patients who previously underwent orthognathic surgery and evaluate the procedures in the second and third surgeries. The patients who underwent orthognathic surgery at Erciyes University between June 2006 and September 2023 were included. The primary outcomes were the reasons for re-operation, and the secondary outcomes were the reasons for plate removal and the location of the removed plates. Reasons for re-operation are classified as plate removal, early malocclusion, late malocclusion, inadequate aesthetic satisfaction, septal deviation, bleeding, and retained foreign bodies. The re-operation rate was found to be 8.33 %. The most common reason for re-operation was plate problems, with 43.53 %. Aesthetic dissatisfaction ranked second among the reasons for re-operation, with 16.47 %. The most common reason for plate removal was infection, with 78.68 %. In conclusion, understanding the underlying causes that may lead to re-operation is crucial in informing patients and minimizing the need for re-operation.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744407","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":"Preoperative platelet-to-lymphocyte ratio and lymphocyte-to-monocyte ratio predict poor prognosis in patients diagnosed with salivary gland adenoid cystic carcinoma.","authors":"Zhibin Yang, Yizhen Wang, Chunyun Wang, Wei Li, Feiyu Wang, Ading He, Nannan Han, Min Ruan","doi":"10.1016/j.jcms.2025.01.017","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.01.017","url":null,"abstract":"<p><strong>Background: </strong>To assess the prognostic utility of preoperative neutrophil-to- lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) in the peripheral blood of patients diagnosed with salivary adenoid cystic carcinoma (SACC).</p><p><strong>Methods: </strong>Data from 310 patients diagnosed with SACC between January 2008 and April 2014 were included. Data were acquired from patient medical records and follow-ups. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off values for NLR, PLR, and LMR. Kaplan-Meier and multivariate Cox regression analyses were used to evaluate the impact of NLR, PLR, and LMR on overall survival.</p><p><strong>Results: </strong>According to ROC curve analysis, the optimal cut-off values for NLR, PLR and LMR were 1.65, 105.13, and 3.38, respectively. A high PLR was significantly associated with cervical lymph node metastasis (P = 0.043), while low LMR was significantly associated with tumor size (P = 0.016). In addition, patients with PLR >105.13 (P < 0.001) and LMR <3.38 (P < 0.001) experienced worse overall survival rates according to univariate analysis. Multivariate Cox proportional hazards regression modeling demonstrated that histological grade, high PLR, and low LMR were independent prognostic factors for overall survival in patients with SACC.</p><p><strong>Conclusions: </strong>Both pretreatment PLR and LMR were independent predictors of poor prognosis in patients with SACC, and may be considered accurate, low-cost, and readily obtainable clinical prognostic parameters.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of platelet concentrates in maxillary sinus lifts: A systematic review and meta-analysis.","authors":"Zepeng Zhao, Yijin Li, Fengyuan Zhang, Lixia Gao, Haiyan Lin","doi":"10.1016/j.jcms.2025.03.009","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.03.009","url":null,"abstract":"<p><strong>Background: </strong>A maxillary sinus lift is a dental surgery that increases bone volume to allow for dental implant insertion. Platelet concentrate (PC) has been proposed as an adjunct to maxillary sinus lift surgery to enhance bone regeneration. The efficacy of PC this surgery is evaluated in this meta-analysis.</p><p><strong>Methods: </strong>We looked for research on PCs used in maxillary sinus lift operations in online databases. Two separate reviewers assessed the possibility of bias after extracting the data. A meta-analysis evaluated the differences in bone regeneration outcomes between PC + graft group and graft only group.</p><p><strong>Results: </strong>The review incorporated a total of 19 RCTs. The results of the meta-analysis demonstrated that the use of PC in maxillary sinus lift procedures significantly facilitated the utilisation and resorption of graft material (MD = -3.05; 95% CI: -4.91, -1.18; p = 0.02), improved new bone height (MD = 0.99; 95% CI: 0.21, 1.77; p = 0.01), and new bone formation/bone formation rate (BFR) (MD = 4.76; 95% CI: 0.98, 8.54; p = 0.01), compared to control groups. However, we found no significant difference in terms of soft tissue formation, implant stability quotient, implant success rate, complication rate, and contact between new and existing bone.</p><p><strong>Conclusion: </strong>This meta-analysis demonstrates that the application of PC as an adjunct to maxillary sinus lift surgery can improve bone regeneration outcomes while not elevating the risk of complications. Further research is necessary to confirm the results and to determine the most effective protocol for the application of PC in clinical settings.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693669","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":"Hybrid optical and electromagnetic navigation for mandibular angle osteotomy.","authors":"Hongbin Shen, Cai Meng, Tao Song, Kai Wu, Yuqi Cheng, Hang Lin","doi":"10.1016/j.jcms.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.03.003","url":null,"abstract":"<p><p>Surgical navigation systems are extensively employed to enhance the accuracy and safety of traditional surgeries. However, current single-mode systems, using either optical navigation or electromagnetic (EM) navigation, suffer from either occlusion or magnetic interference when simultaneously tracking the mandible and surgical saw in mandibular angle osteotomy (MAO). To resolve this, we propose a hybrid optical and EM navigation system (HOENS), utilizing optical navigation to track the surgical saw and EM navigation to track the mandible. A distance-based automatic hybrid navigation strategy is introduced to integrate both navigation approaches, leveraging the strengths of each. We conducted experiments with mandible phantoms to verify the effectiveness and accuracy of HONES. Results demonstrate that under laboratory conditions, with some nearby metallic interference, HOENS achieves an average hybrid navigation accuracy below 2 mm. Further evaluation of magnetic interference from the surgical saw on the EM sensor validated the necessity of our hybrid navigation strategy. Finally, we conducted osteotomy experiments on the mandible phantoms, where HOENS operated normally and provided precise visual guidance, with an average setup time of less than 20 min. Consequently, HOENS is feasible and effective for assisting surgeons in MAO, meeting clinical accuracy requirements, and shows promising potential for future clinical applications.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674861","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}