Matthaios Didagelos, Dimitrios Afendoulis, Areti Pagiantza, Dimitrios Moysidis, Andreas Papazoglou, Charalambos Kakderis, Stylianos Daios, Vasileios Anastasiou, Konstantinos C Theodoropoulos, Antonios Kouparanis, Athanasios Kartalis, Vasileios Kamperidis, George Kassimis, Antonios Ziakas
{"title":"Treatment of radial artery occlusion after transradial coronary catheterization: a review of the literature and proposed treatment algorithm.","authors":"Matthaios Didagelos, Dimitrios Afendoulis, Areti Pagiantza, Dimitrios Moysidis, Andreas Papazoglou, Charalambos Kakderis, Stylianos Daios, Vasileios Anastasiou, Konstantinos C Theodoropoulos, Antonios Kouparanis, Athanasios Kartalis, Vasileios Kamperidis, George Kassimis, Antonios Ziakas","doi":"10.1016/j.hjc.2025.01.008","DOIUrl":"10.1016/j.hjc.2025.01.008","url":null,"abstract":"<p><p>The transradial artery has been established as the default access site for most coronary catheterization procedures with fewer access-related and bleeding complications, rapid hemostasis, early ambulation of the patient, and reduction in all-cause mortality compared with transfemoral access. However, radial artery occlusion (RAO) remains the most frequent complication of coronary catheterization procedures performed via transradial artery access. The purpose of our review was to conduct detailed literature research and summarize all the available treatment strategies for RAO, given the lack of a standardized treatment protocol in the literature. Pharmacological treatment with low-molecular-weight heparin (LMWH) or other anticoagulants, invasive strategies, and pharmaco-invasive methods available in the literature were included in our review. Data were derived from case series, case reports, clinical trials, and observational studies. Eight studies regarding pharmacological treatment with LMWH or any other anticoagulant and seven studies of invasive treatment were included in our review. There were only two randomized studies: one with LMWH (tinzaparin) and one with apixaban. Furthermore, taking into consideration data derived from the above-mentioned studies, a treatment algorithm for RAO was proposed. RAO remains the most frequent complication of coronary procedures with transradial access. Application of preventive strategies and comprehensive knowledge of the risk factors remain the key factors for the reduction of the incidence of this clinical entity. Therapeutic options include anticoagulation regimens and interventional techniques through the distal radial artery. Large, randomized, multicenter studies should be conducted to evaluate the efficacy of the available treatment methods and define a standardized treatment protocol for RAO.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nikolaos A Papakonstantinou, Nektarios Kogerakis, Dimitrios Avgerinos, Socrates Fragoulis, Antigoni Koliopoulou, Georgios Kantidakis, Georgios T Stavridis
{"title":"Aortic annuloplasty with internal geometric ring; single-center midterm outcomes.","authors":"Nikolaos A Papakonstantinou, Nektarios Kogerakis, Dimitrios Avgerinos, Socrates Fragoulis, Antigoni Koliopoulou, Georgios Kantidakis, Georgios T Stavridis","doi":"10.1016/j.hjc.2025.01.007","DOIUrl":"10.1016/j.hjc.2025.01.007","url":null,"abstract":"<p><strong>Objective: </strong>Surgical aortic valve replacement has been the mainstay of treatment against severe aortic insufficiency despite the high incidence of prosthesis-related complications and better long-term outcomes following aortic valve repair. Annuloplasty and leaflet reconstruction are the integral parts of the procedure. Safety and efficacy of HAART internal annuloplasty ring are hereby investigated through mid-term outcomes of a single referral center.</p><p><strong>Methods: </strong>Forty-three consecutive patients with either trileaflet or bicuspid aortic insufficiency along with ascending aorta and/or aortic root enlargement were included. Annular stabilization via the internal ring implantation was attempted, whereas leaflet repair was performed whenever required.</p><p><strong>Results: </strong>Maximum follow-up was 6.3 years, whereas the mean was 2.7 years. Mean age was 54.2 years. At least moderate aortic insufficiency was noted in 69.8% (30/43) of patients, whereas 93% (40/43) of them had an ascending aorta or aortic root over 45 mm. Overall mortality was 2.3% (1/43). No more than mild aortic insufficiency was detected early postoperatively. At the last follow-up, there were 2 cases of ring-related adverse events who were reoperated for aortic valve replacement (4.7%). Mid-term outcomes revealed no more than mild aortic insufficiency, while aortic diameter was less than 50 mm in the vast majority of the patients. New York Heart Association class was also significantly lower compared to preoperatively, although moderate aortic stenosis was present in 16% of our cohort.</p><p><strong>Conclusion: </strong>Geometric ring annuloplasty is an easily reproducible valve-sparing approach. Midterm results, revealing 2.3% mortality and 95.3% freedom from reoperation, are promising, but long-term outcomes are yet to be discovered.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hanselim Lim, Hendry Agustian, Vanny Febriana, Alice Inda Supit
{"title":"Sacubitril/valsartan role in patients with resistant hypertension: a systematic review.","authors":"Hanselim Lim, Hendry Agustian, Vanny Febriana, Alice Inda Supit","doi":"10.1016/j.hjc.2025.01.004","DOIUrl":"10.1016/j.hjc.2025.01.004","url":null,"abstract":"<p><strong>Background: </strong>Sacubitril/valsartan, an angiotensin receptor neprilysin inhibitor (ARNI), shows promising result in treating resistant hypertension (RH) but lacks comprehensive evaluation. We performed a systematic review to assess and compare the efficacy of ARNI in managing RH.</p><p><strong>Methods: </strong>We conducted a systematic search on multiple databases such as Cochrane, ProQuest, PubMed, and Google Scholar. Studies comparing the effects of ARNI on blood pressure in adult RH patients were included in the review. Data extraction and synthesis followed PRISMA guidelines, and the risk of bias was assessed using Cochrane tools. The primary outcome is to determine the effect of ARNI on blood pressure in RH patients, and the secondary outcome was to assess the safety of ARNI in RH patients.</p><p><strong>Results: </strong>Four studies involving 915 RH patients were included in the systematic review. The sacubitril/valsartan dose used ranged between 100 and 400 mg/day. All studies reported a statistically significant reduction in blood pressure, with 24-h blood pressure reduction ranging from 15.8/6.5 to 16.6/9.3 mmHg and office systolic blood pressure reduction ranging from 24.7 to 10.3 mmHg. Additionally, two studies reported improvements in cardiac remodeling and left ventricular function associated with sacubitril/valsartan. The most common adverse events were hypotension and elevated serum potassium levels, though these were minimal and did not require discontinuation of ARNI therapy.</p><p><strong>Conclusion: </strong>Sacubitril/valsartan is a promising alternative to ARB or ACEi in managing RH, offering superior blood pressure reductions and potential benefits in reversing cardiac remodeling, while maintaining a favorable safety profile with minimal risk of serious adverse events.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sex-specific anatomic differences in patients undergoing transcatheter aortic valve implantation: insights from the ST-TAVI registry.","authors":"Andrija Matetic, Ivica Kristić, Nikola Crnčević, Jakša Zanchi, Tea Domjanović Škopinić, Darija Baković Kramarić, Frane Runjić","doi":"10.1016/j.hjc.2025.01.002","DOIUrl":"10.1016/j.hjc.2025.01.002","url":null,"abstract":"<p><strong>Objective: </strong>The anatomic considerations of transcatheter aortic valve implantation (TAVI) have an important role for the procedure planning; however, sex-specific data are lacking.</p><p><strong>Methods: </strong>All eligible cases undergoing evaluation for TAVI procedure in the period from November 2019 to July 2023 at the University Hospital of Split were included. Cardiac computed tomography was analyzed to derive the measures of left ventricular outflow tract (LVOT), aortic root, ascending aorta, and ilio-femoral arteries. A sex-based comparison was conducted using the descriptive statistics.</p><p><strong>Results: </strong>There were 140 female (43.8%) and 180 male patients (56.2%). Female patients had smaller dimensions of aortic annulus (area 391.9 vs. 491.5 mm<sup>2</sup>, p < 0.001), LVOT (area 373.3 vs. 481.8 mm<sup>2</sup>, p < 0.001), and ascending aorta (maximal diameter 32.7 vs. 34.5 mm, p < 0.001), as well as ilio-femoral arteries bilaterally (p < 0.001). There was no significant difference in the proportion of ilio-femoral unfeasibility for transfemoral TAVI procedure, as measured by diameter of ilio-femoral arteries <5.0 mm (9.0% in males vs. 6.1% in females, p = 0.441) and <5.5 mm (24.7% in males vs. 16.7% in females, p = 0.156). Female patients were more likely to receive the smallest valve across different valve platforms (p < 0.001). There were sex-specific differences in the availability of conventional valve sizes across different platforms (p < 0.001). Female patients had significantly higher periprocedural mortality (7.9% vs. 1.7%, p = 0.030), whereas there were no differences in other clinical outcomes and no association of periprocedural mortality with anatomic measures.</p><p><strong>Conclusion: </strong>Female patients showed smaller absolute dimensions of LVOT, aortic root, and ilio-femoral arteries than male patients. There were no differences in the prevalence of ilio-femoral unfeasibility for the transfemoral TAVI procedure; however, there were sex-specific differences in the availability of conventional valve sizes across different platforms. Female patients exhibited a higher periprocedural mortality, with no difference in other clinical outcomes.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dimitrios E Magouliotis, Serge Sicouri, Arian Arjomandi Rad, John Skoularigis, Grigorios Giamouzis, Andrew Xanthopoulos, Anna P Karamolegkou, Alessandro Viviano, Thanos Athanasiou, Basel Ramlawi
{"title":"In-depth computational analysis reveals the significant dysregulation of key gap junction proteins (GJPs) driving thoracic aortic aneurysm development.","authors":"Dimitrios E Magouliotis, Serge Sicouri, Arian Arjomandi Rad, John Skoularigis, Grigorios Giamouzis, Andrew Xanthopoulos, Anna P Karamolegkou, Alessandro Viviano, Thanos Athanasiou, Basel Ramlawi","doi":"10.1016/j.hjc.2025.01.001","DOIUrl":"10.1016/j.hjc.2025.01.001","url":null,"abstract":"<p><strong>Objective: </strong>Thoracic aortic aneurysm (TAA) represents an aortic pathology that is caused by the deranged integrity of the three layers of the aortic wall and is related to severe morbidity and mortality. Consequently, it is crucial to identify the biomarkers implicated in the pathogenesis and biology of TAA. The aim of the current computational study was to assess the differential gene expression profile of the gap junction proteins (GJPs) in patients with TAA to identify novel potential biomarkers for the diagnosis and treatment of this disease.</p><p><strong>Methods: </strong>We implemented bioinformatics methodology to construct the gene network of the GJPs family, evaluate their expression in pathologic aortic tissue excised from patients with TAA, and compare it with healthy controls. We also investigated the related biological functions and miRNA families.</p><p><strong>Results: </strong>We extracted raw data related to the transcriptomic profile of selected genes from a microarray dataset, incorporating 43 TAA and 43 healthy control samples. A total of 17 GJPs were evaluated. Eight GJPs (47%) were downregulated in TAA (GJA3, GJA9, GJA10, GJB1 GJC2, GJD2, GJD3, and GJD4). We also demonstrated the important correlations among the differentially expressed genes (DEGs). Four GJPs (GJA3, GJA9, GJC2, and GJD3) were associated with fair discrimination and calibration traits in predicting TAA presentation. Finally, we performed gene set enrichment analysis (GSEA) and identified the major biological functions and miRNA families (hsa-miR-5001-3p, hsa-miR-942-5p, hsa-miR-7113-3p, hsa-miR-6867-3p, and hsa-miR-4685-3p) associated with the DEGs.</p><p><strong>Conclusion: </strong>These outcomes support the important role of certain gap junction proteins in the pathogenesis of TAA.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Congenital left aortic sinus of valsalva to left ventricle tunnel.","authors":"Leizhi Ku, Shengpeng Guo, Xiaojing Ma","doi":"10.1016/j.hjc.2024.12.008","DOIUrl":"10.1016/j.hjc.2024.12.008","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xinyi Yu, Xin Wang, Siyi Dun, Hua Zhang, Yanli Yao, Zhendong Liu, Juan Wang, Weike Liu
{"title":"Obesity modifies the association between abnormal glucose metabolism and atrial fibrillation in older adults: a community-based longitudinal and prospective cohort study.","authors":"Xinyi Yu, Xin Wang, Siyi Dun, Hua Zhang, Yanli Yao, Zhendong Liu, Juan Wang, Weike Liu","doi":"10.1016/j.hjc.2024.12.007","DOIUrl":"10.1016/j.hjc.2024.12.007","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the modifying role of obesity in the association between abnormal glucose metabolism and atrial fibrillation (AF) risk in older individuals.</p><p><strong>Methods: </strong>From April 2007 to November 2011, 11,663 participants aged ≥60 years were enrolled in the Shandong area. Glucose metabolic status was determined using fasting plasma glucose and hemoglobin A1c levels, and obesity was determined using body mass index (BMI), waist-to-hip ratio (WHR), and visceral fat area (VFA). Obesity-associated metabolic activities were assessed using the adiponectin-to-leptin ratio (ALR), galectin-3, and triglyceride-glucose index (TyG). New-onset AF was diagnosed by ICD-10.</p><p><strong>Results: </strong>During an average of 11.1 years of follow-up, 1343 participants developed AF. AF risks were higher in those with prediabetes, uncontrolled diabetes, and well-controlled diabetes than with normoglycemia. The hazard ratios were decreased by 14.79%, 40.29%, and 25.23% in those with prediabetes; 31.44%, 53.56%, and 41.90% in those with uncontrolled diabetes; and 21.16%, 42.38%, and 27.59% in those with well-controlled diabetes after adjusting for BMI, WHR, and VFA, respectively. The population-attributable risk percentages of general obesity, central obesity, and high VFA for new-onset AF were 10.43%, 34.78%, and 31.30%, respectively. ALR, galectin-3, and TyG significantly mediated the association of BMI, WHR, and VFA with AF risk (all P<sub>adj.</sub> < 0.001).</p><p><strong>Conclusion: </strong>Obesity mediates the association between abnormal glucose metabolism and AF risk in older individuals. WHR is a more effective modifier than BMI and VFA for moderating the association. ALR, TyG, and galectin-3 mediate the moderating effect of obesity on the association between abnormal glucose metabolism and AF risk.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aloysius S.T. Leow , Fang Qin Goh , Benjamin Y.Q. Tan , Jamie S.Y. Ho , William K.F. Kong , Roger S.Y. Foo , Mark Y.Y. Chan , Leonard L.L. Yeo , Ping Chai , A. Geru , Tiong-Cheng Yeo , Siew Pang Chan , Xin Zhou , Gregory Y.H. Lip , Ching-Hui Sia
{"title":"Clinical phenotypes and outcomes of patients with left ventricular thrombus: an unsupervised cluster analysis","authors":"Aloysius S.T. Leow , Fang Qin Goh , Benjamin Y.Q. Tan , Jamie S.Y. Ho , William K.F. Kong , Roger S.Y. Foo , Mark Y.Y. Chan , Leonard L.L. Yeo , Ping Chai , A. Geru , Tiong-Cheng Yeo , Siew Pang Chan , Xin Zhou , Gregory Y.H. Lip , Ching-Hui Sia","doi":"10.1016/j.hjc.2024.08.010","DOIUrl":"10.1016/j.hjc.2024.08.010","url":null,"abstract":"<div><h3>Background</h3><div>Left ventricular thrombus (LVT) can develop in a diverse group of patients with various underlying causes, resulting in divergent natural histories and trajectories with treatment. Our aim was to use cluster analysis to identify unique clinical profiles among patients with LVT and then compare their clinical characteristics, treatment strategies, and outcomes.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study involving 472 patients with LVT whose data were extracted from a tertiary center's echocardiography database, from March 2011 to January 2021. We used the TwoStep cluster analysis method, examining 19 variables.</div></div><div><h3>Results</h3><div>Our analysis of the 472 patients with LVT revealed two distinct patient clusters. Cluster 1, comprising 247 individuals (52.3%), was characterized by younger patients with a lower incidence of traditional cardiovascular risk factors and relatively fewer comorbidities compared with Cluster 2. Most patients had LVT attributed to an underlying ischemic condition, with a larger proportion being due to post-acute myocardial infarction in Cluster 1 (68.8%), and due to ischemic cardiomyopathy in Cluster 2 (57.8%). Notably, patients in Cluster 2 exhibited a reduced likelihood of LVT resolution (hazard ratio [HR] 0.58, 95% confidence interval [CI] 0.44–0.77, <em>p</em> < 0.001) and a higher risk of all-cause mortality (HR 2.27, 95% CI 1.43–3.60, <em>p</em> = 0.001). These associations persisted even after adjusting for variables such as anticoagulation treatment, the presence of left ventricular aneurysms, and specific LVT characteristics such as mobility, protrusion, and size.</div></div><div><h3>Conclusion</h3><div>Through TwoStep cluster analysis, we identified two distinct clinical phenotypes among patients with LVT, each distinguished by unique baseline clinical attributes and varying prognoses.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"81 ","pages":"Pages 65-74"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Katarzyna Dziopa , Karim Lekadir , Pim van der Harst , Folkert W. Asselbergs
{"title":"Digital twins: reimagining the future of cardiovascular risk prediction and personalised care","authors":"Katarzyna Dziopa , Karim Lekadir , Pim van der Harst , Folkert W. Asselbergs","doi":"10.1016/j.hjc.2024.06.001","DOIUrl":"10.1016/j.hjc.2024.06.001","url":null,"abstract":"<div><div>The rapid evolution of highly adaptable and reusable artificial intelligence models facilitates the implementation of digital twinning and has the potential to redefine cardiovascular risk prevention. Digital twinning combines vast amounts of data from diverse sources to construct virtual models of an individual. Emerging artificial intelligence models, called generalist AI, enable the processing of different types of data, including data from electronic health records, laboratory results, medical texts, imaging, genomics, or graphs. Among their unprecedented capabilities are an easy adaptation of a model to previously unseen medical tasks and the ability to reason and explain output using precise medical language derived from scientific literature, medical guidelines, or knowledge graphs. The proposed combination of a digital twinning approach with generalist AI is a path to accelerate the implementation of precision medicine and enhance early recognition and prevention of cardiovascular disease. This proposed strategy may extend to other domains to advance predictive, preventive, and precision medicine and also boost health research discoveries.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"81 ","pages":"Pages 4-8"},"PeriodicalIF":2.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}