Journal of Vascular Access最新文献

{"title":"Impact of residual anastomotic thrombus during surgical thrombectomy and endovascular intervention for arteriovenous graft thrombosis.","authors":"Kentaro Kasa, Takao Ohki, Kota Shukuzawa, Soichiro Fukushima, Hirotsugu Ozawa, Makiko Omori, Miyo Shirouzu, Hikaru Nakagawa, Ryo Nishide","doi":"10.1177/11297298251345992","DOIUrl":"https://doi.org/10.1177/11297298251345992","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical impact of residual thrombus at the anastomotic site during surgical thrombectomy and endovascular intervention for arteriovenous graft (AVG) thrombosis.</p><p><strong>Methods: </strong>This retrospective, single-center cohort study reviewed 203 consecutive cases of vascular access thrombosis treated between January 2015 and December 2023. Among them, 43 cases of AVG thrombosis with a first-time occlusion and successful revascularization were included for analysis. A per-protocol analysis focusing on postintervention outcomes was conducted among patients who underwent surgical thrombectomy and/or endovascular intervention. Residual anastomotic thrombus was assessed on intraoperative final angiography. All cases were divided into those with residual anastomotic thrombus and those without. The primary outcome measure was postintervention assisted primary patency (PAPP). In addition, hazard ratios of each variable for postintervention patency were evaluated using univariate and multivariate analysis.</p><p><strong>Results: </strong>All 43 patients were divided into two groups: 12 patients (27.9%) with residual anastomotic thrombus and 31 patients (72.1%) without residual anastomotic thrombus. During a median follow-up period of 19 months, PAPP was significantly lower in cases with residual anastomotic thrombus than those without (residual thrombus: 38.1% at 90 days, 19.1% at 180 days, and 19.1% at 365 days; non-residual thrombus: 93.2% at 90 days, 85.7% at 180 days, and 74.6% at 365 days; log-rank <i>p</i> < 0.0001). There was no significant difference in postintervention secondary patency between cases with residual anastomotic thrombus and those without (residual thrombus: 75.0% at 90 days, 65.6% at 180 days, and 65.6% at 365 days; non-residual thrombus: 96.8% at 90 days, 96.8% at 180 days, and 93.1% at 365 days; log-rank <i>p</i> = 0.148). Multivariate analysis identified residual thrombus as an independent risk factor for PAPP (hazard ratio 5.57; 95% confidence interval 2.40-12.93; <i>p</i> < 0.0001), as well as variables including endovascular intervention.</p><p><strong>Conclusion: </strong>AVG thrombosis with residual thrombus at the anastomotic site during intervention showed significantly lower PAPP than those without. Residual anastomotic thrombus may be a relevant factor associated with patency outcomes, and further prospective evaluation is warranted to assess its utility as a treatment endpoint of intervention for AVG thrombosis.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251345992"},"PeriodicalIF":1.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188571","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":"The predictive value of inflammatory biomarkers for arteriovenous fistula failure: A systematic review and meta-analysis.","authors":"Marília Oberto da Silva Gobbo, Tanize Louize Milbradt, Alexandre Yamada Fujimura Júnior, Renan Yuji Ura Sudo, Mariane Amado de Paula, Jarbas Rodrigues de Oliveira, Carlos Eduardo Poli-de-Figueiredo","doi":"10.1177/11297298251345510","DOIUrl":"https://doi.org/10.1177/11297298251345510","url":null,"abstract":"<p><strong>Background: </strong>Hemodialysis requires reliable vascular access, and arteriovenous fistulas (AVF) are preferred for their superior patency and fewer complications. However, AVF failure remains high, with 50% becoming nonfunctional within 2 years. Inflammatory biomarkers can contribute to AVF failure, yet the specific biomarkers involved remain to be identified.</p><p><strong>Aim: </strong>We aim to determine the prognostic significance of inflammatory biomarkers in predicting primary AVF failure in hemodialysis patients.</p><p><strong>Methods: </strong>The electronic search was performed in different databases: PubMed, Embase, and Cochrane Library, from inception to June 2024. Statistical analysis was performed using R software 4.3.1. A random-effects model was employed to compute mean differences (MD) and risk ratios (RR) with 95% confidence intervals (CI) for continuous and binary endpoints. The results were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement guideline.</p><p><strong>Results: </strong>A total of 15 studies, encompassing 1809 patients with a mean age of 62 years, were included. Over follow-up ranging from 6 weeks to 26 months, we did not observe a significant difference in the levels of monocyte chemotactic protein 1 (MCP-1; 12.15 pg/mL; 95% CI -14.26 to 38.56; <i>p</i> = 0.37), tumor necrosis factor alpha (TNF-α; 0.90 pg/mL; 95% CI -38.77 to 40.57; <i>p</i> = 0.96) and white blood cells (WBC; 0.31 g/L; 95% CI -0.05 to 0.66; <i>p</i> = 0.09) between the group experiencing AVF maturation and those facing AVF failure. However, there was a significant elevation in C-reactive protein (CRP) levels in the AVF failure group (2.89 mg/L; 95% CI 0.31-5.47; <i>p</i> = 0.03).</p><p><strong>Conclusions: </strong>Despite the increased CRP values within the AVF failure cohort and the significance noted in individual studies, our investigation did not find discernible effects attributable to other inflammatory and fibrotic biomarkers.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251345510"},"PeriodicalIF":1.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188573","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":"Ultrasound-guided placement of central venous catheters in neonates weighing less than 500 g: A case report.","authors":"Carmen Rodriguez-Perez, Elena Pezzotti, Chiara Iacono, Francesco Maria Risso","doi":"10.1177/11297298251345311","DOIUrl":"https://doi.org/10.1177/11297298251345311","url":null,"abstract":"<p><p>Parenteral nutrition (PN) is a vital treatment for critically ill newborns. Inserting a central venous catheter in a neonate to administer PN and other solutions and drugs incompatible with the peripheral route is crucial and is an urgent procedure. Dislocation or loss of the central vascular catheter implies the placement of a new device, and the inability to insert it may become a clinical emergency in this vulnerable population. We describe the insertion technique of an ultrasound-guided non-tunneled centrally inserted central catheter (CICC) placed in an extremely low-weight and extremely preterm neonate, adapting materials used for placing vascular access devices in the superficial veins of neonates.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251345311"},"PeriodicalIF":1.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188574","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":"Fifteen years and counting: A journey of interventions to sustain an arteriovenous graft hemodialysis access.","authors":"Rita Piedade, Jorge Costa-Lima, Jose Miguel Vilas-Boas, Lara Dias, Diogo Domingues-Monteiro, Leandro Nóbrega, Joana Ferreira, Luis Coentrão, Armando Mansilha","doi":"10.1177/11297298251344674","DOIUrl":"https://doi.org/10.1177/11297298251344674","url":null,"abstract":"<p><p>Vascular access (VA) maintenance is challenging in complex dialysis patients, where patient-centered approaches are decisive. Arteriovenous grafts (AVGs) provide an alternative for those unsuitable for autogenous arteriovenous fistula (AVF). However, AVFs and AVGs are prone to complications such as stenosis, aneurysm, and thrombosis, leading to dysfunction and morbidity in these patients. This report focuses on the journey of an extraordinary longevity of a 15-year-old AVG in a 54-year-old female patient, detailing multiple interventions required to maintain its patency. The case also underscores the role of a multidisciplinary team in achieving long-term success.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251344674"},"PeriodicalIF":1.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188478","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":"The impact of multidisciplinary vascular access team creation in incident dialysis patients: A retrospective case-control study.","authors":"Rafael Figueiredo, Miguel Relvas, Hugo Diniz, Joana Ferreira, Jorge Costa Lima, Armando Mansilha, Manuel Pestana, Luís Coentrão","doi":"10.1177/11297298251344069","DOIUrl":"https://doi.org/10.1177/11297298251344069","url":null,"abstract":"<p><strong>Background: </strong>Autologous arteriovenous fistulae (AVF) are the vascular access (VA) of choice for most hemodialysis (HD) patients. Creating multidisciplinary VA teams (MDT) may improve access-related outcomes and patient survival. This study aims to evaluate our center's MDT impact on matured AVFs.</p><p><strong>Methods: </strong>A retrospective case-control analysis was performed, comparing our center's incident HD patients from years 2022 and 2019. An MDT was created in 2021. Patient data was collected from their electronic health record. The primary outcome was the VA typology used for HD initiation. Secondary outcomes were the prevalence of functioning AVFs 12 months after HD initiation and 24-month patient mortality. Clinical predictors of mortality were derived from a combined-year Cox proportional hazard regression model.</p><p><strong>Results: </strong>One hundred and sixty-nine and 184 incident HD patients were included from 2022 and 2019, respectively. There were no significant differences regarding demographic variables, comorbidities, prior nephrology and VA appointments, patients with VA constructed, and the number of non-programmed HD initiations. The number of patients starting HD with a matured AVF was higher in 2022 (50.9% vs 37.5%, <i>p</i> = 0.011), regardless of demographic variables and comorbidities. The number of functioning AVFs at the 12th month of HD was also greater in 2022 (85.2% vs 76.6%, <i>p</i> = 0.041). The cumulative number of AV interventions until 12 months post-HD was similar between years, with fewer AV construction surgeries in 2022 (<i>p</i> < 0.001). Primary patency (<i>p</i> = 0.020) and secondary patency (<i>p</i> < 0.001) were higher in 2022. The 24-month cumulative mortality was lower in 2022 (17.8% vs 27.2%, <i>p</i> = 0.041), with no significant differences regarding the categorized cause of death. In our combined-cohort multivariable analysis, previous myocardial infarction (HR 1.86, <i>p</i> = 0.034) and dementia (HR 2.61, <i>p</i> = 0.016) were predictors of 24-month mortality. VA construction (HR 0.36, <i>p</i> = 0.013) was a negative predictor.</p><p><strong>Conclusion: </strong>In our center, the MDT creation was associated with a significantly increased number of matured AVFs at HD initiation and after 12 months of HD. Twenty-four-month patient mortality was lower post-MDT creation.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251344069"},"PeriodicalIF":1.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188572","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":"Iatrogenic vertebro-jugular fistula: Case report.","authors":"Aravindhmozhi P, Charankumar Swamikkannu, Kalpana Sivalingam, Mohanraj Periyasamy, Rinesh Kochummen, Sakthirajan Ramanathan, Natarajan Gopalakrishnan","doi":"10.1177/11297298251342296","DOIUrl":"https://doi.org/10.1177/11297298251342296","url":null,"abstract":"<p><p>Internal jugular vein (IJV) cannulation is one of the most commonly used procedure in intensive care units and hemodialysis setting. With ultrasound-guided cannulations, the incidence of complications has significantly decreased. We report a patient who developed vertebro-jugular fistula post internal jugular vein cannulation and was successfully treated with a stent graft placed using an endovascular technique. In the literature, very few similar cases have been reported so far.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251342296"},"PeriodicalIF":1.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188570","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":"Port REMoval Outcomes (PREMO) study: Patients' experiences with a Totally Implantable Venous Access Device: A questionnaire at device removal.","authors":"Godelieve Alice Goossens, Thomas Douchy, Martine Jérôme, Yorick Peeters, Daphne Hompes, Veerle Boecxstaens","doi":"10.1177/11297298251340461","DOIUrl":"https://doi.org/10.1177/11297298251340461","url":null,"abstract":"<p><strong>Background: </strong>Totally Implantable Venous Access Devices (TIVADs) are commonly used for intravenous chemotherapy administration and may remain in place depending on the likelihood of disease relapse. Regular flushing is required to maintain patency, although there is no established consensus on the optimal interval between maintenance sessions, with some clinicians extending or omitting the procedure. While TIVADs are generally well-accepted, patients may experience physical discomfort or psychological stress, which are assessed through Patient Reported Outcomes (PROs). This study aims to evaluate the complete TIVAD experience, from insertion to removal, with a particular focus on the maintenance period, as part of the Port REMoval Outcomes (PREMO) study.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted at University Hospitals Leuven, Belgium between 2019 and 2022. Adult patients with chest TIVADs, planned for an elective removal, completed the Leuven Patient Reported Experiences at Port Removal (Leuven PREP) a self-reported, self-developed 27-item questionnaire.</p><p><strong>Results: </strong>A total of 100 oncology patients completed the questionnaire, with a mean age of 60.9 years and a median TIVAD duration of 2093 days. Most patients reported low insertion pain (median NRS score = 2), while emotional and psychological impacts were generally minimal, with only 1% expressing constant fear. Local discomfort was mentioned, with 24.5% reporting a bump and 12% experiencing pain during needle insertion; 10% experienced frequent cosmetic issues. TIVAD maintenance adherence was limited to 70.7% following the flushing regimen, and 61.2% found extending the maintenance period valuable. The removal procedure was well-received, with 60.2% reporting it was better than expected, and overall patient satisfaction was high, with a median score of 8/10.</p><p><strong>Conclusion: </strong>Patients expressed high satisfaction with low impact on comfort, psychological state and physical well-being. Maintenance experiences varied, highlighting the need for further investigation and a validated comprehensive questionnaire.</p><p><strong>Registration number: </strong>NCT03948958.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251340461"},"PeriodicalIF":1.6,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153014","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":"Arteriovenous fistula after distal transradial access: A case report and literature review.","authors":"Xinyu Fan, Tao Chen, Feng Li, Ganwei Shi, Ruixiao Song, Gaojun Cai","doi":"10.1177/11297298251342303","DOIUrl":"https://doi.org/10.1177/11297298251342303","url":null,"abstract":"<p><strong>Background: </strong>Distal transradial access (dTRA) has received extensive attention and has gradually become an alternative access for cardiac interventions. However, with the widespread use of dTRA, access complications such as distal radial artery occlusion (dRAO), haematoma, pseudoaneurysm and arteriovenous fistula (AVF) have been reported. In this study, we report a case of AVF after dTRA and review the related literature.</p><p><strong>Case report: </strong>A 54-year-old female, who underwent percutaneous coronary intervention (PCI) 2 years ago, was admitted to the hospital with discomfort in her thumb. On admission, a mass was found at the puncture site, and ultrasound revealed a fistula between the distal radial artery (DRA) and the cephalic vein (CV). The patient was treated with manual compression for 2 h. Three months later, the mass was smaller than before, the symptoms had resolved and the fistula was found to have closed on repeat ultrasound.</p><p><strong>Conclusion: </strong>Understanding the mechanisms underlying the occurrence of AVF and the principles guiding the treatment of the potential risks associated with AVF after dTRA is important and allows for the effective prevention of AVF and accurate prognostic prediction.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251342303"},"PeriodicalIF":1.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120151","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":"Evaluating needle-free connectors associated backflow in Midline and peripherally inserted central catheters: A top bench study.","authors":"Daniele Privitera, Davide Giustivi, Elisa Nardin, Enrico Gianfranceschi, Stefania Fiorini, Elisabetta Fiorina, Silvia Revere, Nicolò Capsoni","doi":"10.1177/11297298251340469","DOIUrl":"https://doi.org/10.1177/11297298251340469","url":null,"abstract":"<p><strong>Background: </strong>Needle-free connectors (NFCs) are closure systems for vascular catheters largely used because effectively reduce needlestick incidents. They are classified based on their impact on the fluid column within the catheter as <i>positive</i> (fluid displacement into the vein), <i>negative</i> (fluid displacement back from the vein into the catheter), <i>neutral</i> (minimal displacement), or <i>anti-reflux</i> (equipped with additional anti-reflux valve). Each category has specific usage and clamping procedures. This study aimed to evaluate the backflow volume (BV) when different NFC categories and clamping sequences are used with a peripherally inserted central catheter (PICC) and a Midline catheter (MC).</p><p><strong>Methods: </strong>In this bench study, four types of NFCs with different flow displacement behavior were studied. Each NFC was evaluated using two different catheters: a 4 Fr × 60 cm single-lumen catheter (PICC), and a 4 Fr × 25 cm single-lumen catheter (MC). The experimental model simulated the physiological blood pressure of the superior vena cava. Three operators performed specific sealing sequences for each combination of NFC and catheter. After that, the BV (mm³) inside the catheter for every NFC was assessed.</p><p><strong>Results: </strong>None of the four NFCs was able to avoid the BV into the catheter. Positive NFC showed a lower BV as compared to the other three NFCs when tested with PICC: 0.83 [0.76-0.95] mm³ versus 1.14 [0.95-1.53] mm³ of Q-SYTE, versus 1.27 [1.02-1.59] mm³ of Neutron, versus 1.24 [0.95-1.84] mm³ of Bionector, whereas no differences were observed when tested with Midline. No differences were observed between different clamping sequences when used with <i>neutral</i> and <i>anti-reflux</i> NFCs.</p><p><strong>Conclusion: </strong>This study examined the performance of various NFC technologies with PICC and Midline. While no device eliminates BV, positive displacement NFCs showed lower flow reflux compared to the others when used with PICC. No difference between clamping sequences was observed for <i>neutral</i> and <i>anti-reflux</i> NFCs.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251340469"},"PeriodicalIF":1.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120371","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":"A rare case of revascularization of chronically occluded brachial artery with an old-long-segment thrombus by using Fogarty adherent clot catheter and ultrasound guidance.","authors":"Xi Zhang, Sifeng Huang, Ling Chen, Xuejing Gao, Qiquan Lai, Bo Tu, Ziming Wan","doi":"10.1177/11297298251342294","DOIUrl":"https://doi.org/10.1177/11297298251342294","url":null,"abstract":"<p><p>Arterial old-long-segment thrombus is a difficult-to-handle complication in brachio-cephalic fistula, leading to totally chronic occlusion, fistula dysfunction, and potential upper limb ischemia. This case study presented the successful clinical experience of using Fogarty adherent clot catheter to remove an old-long-segment thrombus (15 cm) in the brachial artery, which was guided by ultrasound. The procedure resulted in long-term patency of the arteriovenous fistula with no early or delayed complications. This study highlighted the effectiveness, safety, and practicality of this procedure, offering the advantages of brachial artery revascularization to prevent further ischemic complications, preserve valuable vascular access, and maintain full functionality, minimal trauma, and reduced radiation exposure.</p>","PeriodicalId":56113,"journal":{"name":"Journal of Vascular Access","volume":" ","pages":"11297298251342294"},"PeriodicalIF":1.6,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121647","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}