Computer Assisted Surgery最新文献

{"title":"Monte Carlo-based rendering of 3D echocardiography for mixed reality-guided atrial septal puncture positioning.","authors":"Dharani Dhar Maddali, Håvard Solvin, Matthias Lippert, Yücel Karabiyik, Gry Dahle, Jon Mikkelsen Hjelmervik, Gabriel Kiss, Ole Jakob Elle, Henrik Brun","doi":"10.1080/24699322.2024.2403444","DOIUrl":"https://doi.org/10.1080/24699322.2024.2403444","url":null,"abstract":"<p><p>Catheter-based intervention procedures contain complex maneuvers, and they are often performed using fluoroscopic guidance assisted by 2D and 3D echocardiography viewed on a flat screen that inherently limits depth perception. Emerging mixed reality (MR) technologies, combined with advanced rendering techniques, offer potential enhancement in depth perception and navigational support. The study aims to evaluate a MR-based guidance system for the atrial septal puncture (ASP) procedure utilizing a phantom anatomical model. A novel MR-based guidance system using a modified Monte Carlo-based rendering approach for 3D echocardiographic visualization was introduced and evaluated against standard clinical 3D echocardiographic display on a flat screen. The objective was to guide the ASP procedure by facilitating catheter placement and puncture across four specific atrial septum quadrants. To assess the system's feasibility and performance, a user study involving four experienced interventional cardiologists was conducted using a phantom model. Results show that participants accurately punctured the designated quadrant in 14 out of 16 punctures using MR and 15 out of 16 punctures using the flat screen of the ultrasound machine. The geometric mean puncture time for MR was 31 s and 26 s for flat screen guidance. User experience ratings indicated MR-based guidance to be easier to navigate and locate tents of the atrial septum. The study demonstrates the feasibility of MR-guided atrial septal puncture. User experience data, particularly with respect to navigation, imply potential benefits for more complex procedures and educational purposes. The observed performance difference suggests an associated learning curve for optimal MR utilization.</p>","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"29 1","pages":"2403444"},"PeriodicalIF":1.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301865","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":"Early postoperative efficacy of a fully automated orthopedic robotic system-assisted percutaneous pedicle screw fixation for isthmic spondylolisthesis.","authors":"Li Zongze,Cheng Yongquan,Zeng Guanjie,Zhu Yongjian,Cui Yuhui,Jiang Hui,Chen Jianting","doi":"10.1080/24699322.2024.2399502","DOIUrl":"https://doi.org/10.1080/24699322.2024.2399502","url":null,"abstract":"To assess the feasibility of percutaneous pedicle screw fixation assisted by a fully automated orthopedic robotic system for the treatment of isthmic spondylolisthesis and evaluate its early postoperative outcome. Totally 20 patients with isthmic spondylolisthesis who underwent surgical procedure by the same medical group from March 2020 to March 2023 were retrospectively analyzed, including 10 patients in the robot-assisted group (RA group) and the other 10 patients in the conventional free-hand technique group (FH group). Accuracy of screw insertion was determined using the Gertzbein-Robbins Scale. The accuracy of the novel robotic system was evaluated by comparing the screw position in the preoperative planning and measuring the entry point deviation distance and the trajectory rotation. The differences in operative time, intraoperative blood loss, radiographic fluoroscopy time and fluoroscopic dosage, and length of hospital stay were compared between the two groups. The lumbar visual analog scale scores before and 7 days after operation were analyzed to evaluate the improvement of low back pain as the early postoperative outcome. A total of 84 pedicle screws were placed. In the RA group, 97.5% of screws were Grade A, and 2.5% were Grade B. In the FH group, 88.6% of screws were Grade A, 9.1% were Grade B, and 2.3% were Grade C. No statistical difference was found in the operation time between two groups. The RA group showed a significant reduction in intraoperative blood loss, radiographic fluoroscopy time and fluoroscopic dosage, and length of hospital stay compared to the FH group. The low back pain in both groups was significantly improved after the operation. The novel orthopedic robotic system-assisted percutaneous pedicle screw fixation, with accurate intraoperative screw placement, less surgical damage, less fluoroscopy and shorter length of hospital stay, can be safe and effective for the surgical treatment of isthmic spondylolisthesis.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"27 1","pages":"2399502"},"PeriodicalIF":2.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142193996","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":"Virtual surgical planning in craniomaxillofacial surgery: a structured review.","authors":"Kaye Velarde, Rentor Cafino, Armando Isla, Karen Mae Ty, Xavier-Lewis Palmer, Lucas Potter, Larry Nadorra, Luchin Valrian Pueblos, Lemuel Clark Velasco","doi":"10.1080/24699322.2023.2271160","DOIUrl":"10.1080/24699322.2023.2271160","url":null,"abstract":"<p><p>Craniomaxillofacial (CMF) surgery is a challenging and very demanding field that involves the treatment of congenital and acquired conditions of the face and head. Due to the complexity of the head and facial region, various tools and techniques were developed and utilized to aid surgical procedures and optimize results. Virtual Surgical Planning (VSP) has revolutionized the way craniomaxillofacial surgeries are planned and executed. It uses 3D imaging computer software to visualize and simulate a surgical procedure. Numerous studies were published on the usage of VSP in craniomaxillofacial surgery. However, the researchers found inconsistency in the previous literature which prompted the development of this review. This paper aims to provide a comprehensive review of the findings of the studies by conducting an integrated approach to synthesize the literature related to the use of VSP in craniomaxillofacial surgery. Twenty-nine related articles were selected as a sample and synthesized thoroughly. These papers were grouped assigning to the four subdisciplines of craniomaxillofacial surgery: orthognathic surgery, reconstructive surgery, trauma surgery and implant surgery. The following variables - treatment time, the accuracy of VSP, clinical outcome, cost, and cost-effectiveness - were also examined. Results revealed that VSP offers advantages in craniomaxillofacial surgery over the traditional method in terms of duration, predictability and clinical outcomes. However, the cost aspect was not discussed in most papers. This structured literature review will thus provide current findings and trends and recommendations for future research on the usage of VSP in craniomaxillofacial surgery.</p>","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"28 1","pages":"2271160"},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685405","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":"Performance assessment of surgical tracking systems based on statistical process control and longitudinal QA.","authors":"I Butz, M Fernandez, A Uneri, N Theodore, W S Anderson, J H Siewerdsen","doi":"10.1080/24699322.2023.2275522","DOIUrl":"10.1080/24699322.2023.2275522","url":null,"abstract":"<p><p>A system for performance assessment and quality assurance (QA) of surgical trackers is reported based on principles of geometric accuracy and statistical process control (SPC) for routine longitudinal testing. A simple QA test phantom was designed, where the number and distribution of registration fiducials was determined drawing from analytical models for target registration error (TRE). A tracker testbed was configured with open-source software for measurement of a TRE-based accuracy metric <math><mi>ε</mi></math> and Jitter (<math><mi>J</mi></math>). Six trackers were tested: 2 electromagnetic (EM - Aurora); and 4 infrared (IR - 1 Spectra, 1 Vega, and 2 Vicra) - all NDI (Waterloo, ON). Phase I SPC analysis of Shewhart mean (<math><mrow><mrow><mrow><mover><mrow><mi>x</mi></mrow><mo>¯</mo></mover></mrow></mrow></mrow></math>) and standard deviation (<math><mi>s</mi></math>) determined system control limits. Phase II involved weekly QA of each system for up to 32 weeks and identified Pass, Note, Alert, and Failure action rules. The process permitted QA in <1 min. Phase I control limits were established for all trackers: EM trackers exhibited higher upper control limits than IR trackers in <math><mi>ε</mi></math> (EM: <math><mrow><msub><mrow><mrow><mrow><mrow><mover><mrow><mi>x</mi></mrow><mo>¯</mo></mover></mrow></mrow></mrow></mrow><mrow><mi>ε</mi></mrow></msub></mrow><mi> </mi><mo>∼</mo></math>2.8-3.3 mm, IR: <math><mrow><msub><mrow><mrow><mrow><mrow><mover><mrow><mi>x</mi></mrow><mo>¯</mo></mover></mrow></mrow></mrow></mrow><mrow><mi>ε</mi></mrow></msub></mrow><mi> </mi><mo>∼</mo></math>1.6-2.0 mm) and Jitter (EM: <math><mrow><msub><mrow><mrow><mrow><mrow><mover><mrow><mi>x</mi></mrow><mo>¯</mo></mover></mrow></mrow></mrow></mrow><mrow><mi>jitter</mi></mrow></msub></mrow><mi> </mi><mo>∼</mo></math>0.30-0.33 mm, IR: <math><mrow><msub><mrow><mrow><mrow><mrow><mover><mrow><mi>x</mi></mrow><mo>¯</mo></mover></mrow></mrow></mrow></mrow><mrow><mi>jitter</mi></mrow></msub></mrow><mi> </mi><mo>∼</mo></math>0.08-0.10 mm), and older trackers showed evidence of degradation - e.g. higher Jitter for the older Vicra (<i>p</i>-value < .05). Phase II longitudinal tests yielded 676 outcomes in which a total of 4 Failures were noted - 3 resolved by intervention (metal interference for EM trackers) - and 1 owing to restrictive control limits for a new system (Vega). Weekly tests also yielded 40 Notes and 16 Alerts - each spontaneously resolved in subsequent monitoring.</p>","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"28 1","pages":"2275522"},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523503","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":"Research on augmented reality navigation of in vitro fenestration of stent-graft based on deep learning and virtual-real registration.","authors":"Fengfeng He, Xiaoyu Qi, Qingmin Feng, Qiang Zhang, Ning Pan, Chao Yang, Shenglin Liu","doi":"10.1080/24699322.2023.2289339","DOIUrl":"10.1080/24699322.2023.2289339","url":null,"abstract":"<p><strong>Objectives: </strong><i>In vitro</i> fenestration of stent-graft (IVFS) demands high-precision navigation methods to achieve optimal surgical outcomes. This study aims to propose an augmented reality (AR) navigation method for IVFS, which can provide <i>in situ</i> overlay display to locate fenestration positions.</p><p><strong>Methods: </strong>We propose an AR navigation method to assist doctors in performing IVFS. A deep learning-based aorta segmentation algorithm is used to achieve automatic and rapid aorta segmentation. The Vuforia-based virtual-real registration and marker recognition algorithm are integrated to ensure accurate <i>in situ</i> AR image.</p><p><strong>Results: </strong>The proposed method can provide three-dimensional <i>in situ</i> AR image, and the fiducial registration error after virtual-real registration is 2.070 mm. The aorta segmentation experiment obtains dice similarity coefficient of 91.12% and Hausdorff distance of 2.59, better than conventional algorithms before improvement.</p><p><strong>Conclusions: </strong>The proposed method can intuitively and accurately locate fenestration positions, and therefore can assist doctors in performing IVFS.</p>","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"28 1","pages":"2289339"},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138500344","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":"Biomechanical behavior of the three-dimensionally printed surgical plates for mandibular defect reconstruction: a finite element analysis.","authors":"Chao-Fei Wang, Shuo Liu, Lei-Hao Hu, Yao Yu, Xin Peng, Wen-Bo Zhang","doi":"10.1080/24699322.2023.2286181","DOIUrl":"10.1080/24699322.2023.2286181","url":null,"abstract":"<p><p>The aim of the study was to investigate the biomechanical behavior of three-dimensionally (3D)-printed surgical plates used for mandibular defect reconstruction, compare them with conventional surgical plates, and provide experimental evidence for their clinical application. Three-dimensional models were created for the normal mandible and for mandibular body defects reconstructed using free fibula and deep circumflex iliac artery flaps. Three-dimensional finite element models of reconstructed mandibles fixed using 3D-printed and conventional surgical plates were established. Vertical occlusal forces were applied to the remaining teeth and the displacement and Von Mises stress distributions were studied using finite element analysis. The normal and reconstructed mandibles had similar biomechanical behaviors. The displacement distributions for the surgical plates were similar, and the maximum total deformation occurred at the screw hole of the anterior segment of the surgical plates. However, there were differences in the Von Mises stress distributions for the surgical plates. In reconstructed mandibles fixed using 3D-printed surgical plates, the maximum equivalent Von Mises stress occurred at the screw hole of the posterior segment, while in those fixed using conventional surgical plates, the maximum equivalent Von Mises stress was at the screw hole of the anterior segment. In the mandible models reconstructed with the same free flap but fixed with different surgical plates, the plates had similar biomechanical behaviors. The biomechanical behavior of 3D-printed surgical plates was similar to conventional surgical plates, suggesting that 3D-printed surgical plates used to reconstruct mandibular body defects with vascularized autogenous bone grafts could lead to secure and stable fixation.</p>","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"28 1","pages":"2286181"},"PeriodicalIF":2.1,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138447210","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":"Tibial component rotation alters soft tissue balance in a cruciate retaining total knee arthroplasty","authors":"G. Clark, M. Quinn, J. Murgier, D. Wood","doi":"10.1080/24699322.2022.2078738","DOIUrl":"https://doi.org/10.1080/24699322.2022.2078738","url":null,"abstract":"Abstract Our aim was to understand whether using different landmarks for tibial component rotation influenced articular contact pressures in a balanced total knee arthroplasty (TKA). Twelve patients underwent TKA (Triathlon CR, Stryker Inc., Mahwah, NJ) and contact pressures were assessed using a wireless sensor. Robotic arm assisted TKA using a functional alignment technique was performed, with balanced gaps between medial and lateral compartments. Compartment pressures were measured with the trial tibial component rotated to Akagi's line and to Insall's axis respectively. Rotating the tibial component to Akagi's line resulted in a significantly greater proportion of knees being balanced and lower contact pressures than when the tibial component was rotated to Insall's axis at 10°, 45° and 90° of flexion (p < 0.05). Medial compartment pressures were significantly increased in 10° of flexion, as were lateral compartment pressures in all positions when the tibial component was aligned to Insall's axis (p < 0.05). The mean difference in rotation observed with the two landmarks was 6.9° (range 4.1–9.1°). Rotational alignment of the tibial component using Akagi's line reduced contact pressures, improved balance and reduced the need for soft tissue release when compared with Insall's axis in robotic arm assisted TKA.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"27 1","pages":"35 - 40"},"PeriodicalIF":2.1,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42933436","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":"Dimensional accuracy of TKA cut surfaces with an active robotic system","authors":"S. Kreuzer, A. Brar, V. Campanelli","doi":"10.1080/24699322.2022.2080116","DOIUrl":"https://doi.org/10.1080/24699322.2022.2080116","url":null,"abstract":"Abstract This is a study of the dimensional accuracy of the bone cut surfaces in robotic TKA. One surgeon performed robotic TKA on four cadaveric knees. A novel technique was developed for measuring the dimensional accuracy of both the femoral and tibial cut surfaces. CT scans were used to create a pre-operative plan and generate nominal cut surfaces on the 3D bone model. After TKA, the cut surfaces were then laser scanned. Two femoral components were also scanned and compared to nominal dimensions. Flatness was computed as the standard deviation between each of the cut surfaces and the best-fit plane. The angles between the five femoral best-fit planes were compared to the nominal values. The point-to-point distances between the femoral cut surfaces and the nominal cut planes were computed to estimate the bone-to-implant gap. The cut surfaces had an average flatness of 0.16 ± 0.06 mm with low variability between different cut planes. The femoral cut surfaces had average angular errors of 0.47 ± 0.39°, which are of similar magnitude as the errors found for the implants. The bone-to-implant gap was within ±1 mm for 97.9% of the surface on average. Using a novel methodology, the dimensional accuracy of an active robotic system for TKA was found to be very high for both the femoral and tibial bone cuts. Comparison studies are needed with other robotic systems as well as studies comparing manual and robotic techniques.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"27 1","pages":"41 - 49"},"PeriodicalIF":2.1,"publicationDate":"2022-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44754199","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":"Deep learning for assessing liver fibrosis based on acoustic nonlinearity maps: an in vivo study of rabbits","authors":"Jinzhen Song, Hao Yin, Jianbo Huang, Zhenru Wu, Chenchen Wei, Tingting Qiu, Yan Luo","doi":"10.1080/24699322.2022.2063760","DOIUrl":"https://doi.org/10.1080/24699322.2022.2063760","url":null,"abstract":"Abstract This study aimed to assess liver fibrosis in rabbits by deep learning models based on acoustic nonlinearity maps. Injection of carbon tetrachloride was used to induce liver fibrosis. Acoustic nonlinearity maps, which were built by data of echo signals, were used as input data for deep learning model. Convolutional neural network (CNN), CNN combined with support vector machine (SVM), CNN combined with random forest and CNN combined with logistic regression were used as deep learning model. Nested 10-fold cross-validation was used to search hyperparameters and evaluate performance of models. Histologic examination of liver specimens of the rabbits was performed to evaluate the fibrosis stage. Receiver operator characteristic curve and area under curve (AUC) were used for estimating the probability of the correct prediction of liver fibrosis stages. A total of 600 acoustic nonlinearity maps were used. Model of CNN combined with SVM demonstrated the best diagnostic performance compared with all other methods for diagnosis of significant fibrosis (≥F2, AUC = 0.82), advanced fibrosis (≥F3, AUC = 0.88) and cirrhosis (F4, AUC = 0.90). Model of CNN showed the second highest AUCs. The deep learning model based on acoustic nonlinearity maps demonstrated potential for evaluation of liver fibrosis.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"27 1","pages":"15 - 26"},"PeriodicalIF":2.1,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60126434","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":"Optimal definitions for computing HKA angle in caos: an in-vitro comparison study","authors":"G. Dardenne, B. Borotikar, H. Letissier, A. Zemirline, E. Stindel","doi":"10.1080/24699322.2022.2066023","DOIUrl":"https://doi.org/10.1080/24699322.2022.2066023","url":null,"abstract":"Abstract The goal of this study was to assess and compare the precision and accuracy of nine and seven methods usually used in Computer Assisted Orthopedic Surgery (CAOS) to estimate respectively the Knee Center (KC) and the Frontal Plane (FP) for the determination of the HKA angle (HKAA). An in-vitro experiment has been realized on thirteen cadaveric lower limbs. A CAOS software application was developed and allowed the computation of the HKAA according to these nine KC and seven FP methods. The precision and the accuracy of the HKAA measurements were measured. The HKAA precision was highest when the FP is determined using the helical method. The HKAA accuracy was highest using the helical approach to determine the FP and either the notch or the tibial spines to determine the KC. This study shows that the helical approach to determine the FP and either the notch or the middle of tibia spines are the combinations that provide both a good enough accuracy and precision to estimate the HKA.","PeriodicalId":56051,"journal":{"name":"Computer Assisted Surgery","volume":"27 1","pages":"27 - 34"},"PeriodicalIF":2.1,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48667374","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}