Acta Otorhinolaryngologica Italica最新文献

{"title":"Prognostic value of changes in pre- and postoperative inflammatory blood markers in HPV-negative head and neck squamous cell carcinomas.","authors":"Tommaso Mazzocco, Andrea Migliorelli, Giancarlo Tirelli, Michele Tomasoni, Vittorio Rampinelli, Cesare Piazza, Marco Ferrari, Piero Nicolai, Vittorio Baggio, Valentina Lupato, Francesco Uderzo, Franco Trabalzini, Simone Mauramati, Andrea Ciorba, Fabiola Giudici, Jerry Polesel, Daniele Borsetto, Paolo Boscolo-Rizzo","doi":"10.14639/0392-100X-N2955","DOIUrl":"10.14639/0392-100X-N2955","url":null,"abstract":"<p><strong>Objective: </strong>Neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) are inflammatory markers easily obtained from a routine complete blood count, and their preoperative values have recently been correlated with oncological outcomes in patients with HPV-negative head and neck squamous cell carcinoma (HNSCC). The aim of this study is to evaluate the prognostic value of NLR and LMR before and after treatment in patients with HPV-negative HNSCC undergoing up-front surgical treatment.</p><p><strong>Methods: </strong>This multicentric retrospective study was performed on a consecutive cohort of patients treated by upfront surgery for HPV-negative HNSCC between April 2004 and June 2018. Only patients whose pre- and postoperative NLR and LMR were available were included. Their association with local, regional and distant failure, progression-free survival (PFS) and overall survival (OS) was calculated.</p><p><strong>Results: </strong>A total of 493 patients (mean age 68 years) were enrolled. The mean follow-up time was 54 months. Pre-surgical NLR ≥ 3.76 was associated with a high risk of regional failure (HR = 2.21, 95% CI: 1.08-5.55), disease progression (HR = 1.55, 95% CI: 1.07-2.25) and death (HR = 1.40, 95% CI: 0.94-2.10). A post-surgical LMR < 2.92 had a significant impact on disease progression (HR = 1.92, 95% CI: 1.13-3.28) and OS (HR = 2.98, 95% CI: 1.53-5.81). Patients with stable NLR ≥ 3.76 in the pre- and postoperative period had worse OS and PFS.</p><p><strong>Conclusions: </strong>Our results support that pre- and postoperative NLR and LMR can be useful in identifying patients at risk of local, regional, or distant recurrence who may require closer follow-up or more aggressive treatment.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"45 1","pages":"10-20"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bama pig is a suitable animal for studying laryngopharyngeal reflux disease.","authors":"Qingyang Shi, Yuguang Wang, Lihong Zhang, Haiyan An","doi":"10.14639/0392-100X-N2734","DOIUrl":"10.14639/0392-100X-N2734","url":null,"abstract":"<p><strong>Objective: </strong>To assess the suitability of Bama pigs as a model for laryngopharyngeal reflux disease (LPRD) research.</p><p><strong>Methods: </strong>Sixteen 8-month-old male Bama pigs underwent esophageal manometry to determine the precise anatomical positioning of the upper (UES) and lower esophageal sphincters (LES) relative to the incisor teeth, as well as their respective contraction intensities. The pigs were randomly allocated into three experimental groups (n = 6, 5, 5), with each group subjected to Dx PH-probe monitoring. In Group 1, animals were fasted for 24 hours and water-deprived for 6 hours before undergoing pH monitoring under anaesthesia. Group 2 was anaesthetised two hours post-normal feeding and subsequently monitored. Group 3 also received anaesthesia two hours after eating but were monitored in an awake state.</p><p><strong>Results: </strong>The mean distance from the UES to the incisor teeth was found to be 19.8 ± 1 cm, while the LES was located at 40 ± 2.5 cm. The resting pressure measurements revealed a mean value of 64 ± 12 mmHg for the UES and 20 ± 4 mmHg for the LES in Bama pigs. Laryngopharyngeal pH values across the three groups were 7 ± 0.6, 7 ± 0.5, and 7.4 ± 1.2, respectively, showing no significant differences or reflux events. Similarly, there was no statistically significant difference in the lower oesophageal pH between Group 1 and Group 2.</p><p><strong>Conclusions: </strong>The Bama pig emerges as a suitable animal model for studying LPRD, given its comparable physiological parameters. The feasibility of establishing a reflux model in Bama pigs and using it to investigate the underlying mechanisms of LPRD is convincingly supported by these findings.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"45 1","pages":"21-27"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete response of laryngeal papillomatosis after HPV vaccination.","authors":"Alberto Paderno, Isabelle Matilde Dohin, Francesca Gennarini","doi":"10.14639/0392-100X-N2990","DOIUrl":"10.14639/0392-100X-N2990","url":null,"abstract":"","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":" ","pages":"70-72"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142278603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of body mass index as a predictor of dupilumab efficacy in patients with severe chronic rhinosinusitis with nasal polyps.","authors":"Letizia Nitro, Eugenio De Corso, Marco Borin, Alberto Maria Saibene, Flavio Arnone, Francesco Ferella, Giulia Gramellini, Alessandro Cantiani, Gabriele De Maio, Camilla Spanu, Alberto Giulio Dragonetti, Giovanni Felisati, Carlotta Pipolo","doi":"10.14639/0392-100X-N2841","DOIUrl":"10.14639/0392-100X-N2841","url":null,"abstract":"<p><strong>Objective: </strong>Response to dupilumab for chronic rhinosinusitis with nasal polyps, albeit almost always excellent, is still not predictable. Our study focuses on the role of body mass index (BMI) on the efficacy of dupilumab.</p><p><strong>Methods: </strong>We present a retrospective multicentre study of 106 patients on dupilumab, stratified in 3 subgroups of BMI. The main therapeutic outcomes investigated were Nasal Polyp Score (NPS), Sino-Nasal-Outcome Test - 22 (SNOT-22), Sniffin' Sticks Identification test and visuo-analogical scale, and the different timing of response, according to De Corso et al. criteria.</p><p><strong>Results: </strong>Dupilumab treatment led to a progressive improvement for all outcomes at all time points. Comparing the different metabolic subgroups, a late response in terms of decrease in NPS was observed only in 3 obese patients. A significant decrease was also found in SNOT-22 score at 6 and 12 months, which was less marked in overweight/obese patients.</p><p><strong>Conclusions: </strong>Our study confirmed the efficacy of dupilumab in each BMI subgroup. However, the efficacy seems to follow different timing with respect to patients' BMI. Our data suggest that patients with a compromised metabolic state present more severe disease at baseline and a possibly delayed response to dupilumab.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"45 1","pages":"28-38"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood and local nasal eosinophilia in chronic rhinosinusitis with nasal polyps: prevalence and correlation with severity of disease.","authors":"Eugenio De Corso, Marco Corbò, Claudio Montuori, Daniela Furno, Veronica Seccia, Tiziana Di Cesare, Carlotta Pipolo, Silvia Baroni, Rodolfo Mastrapasqua, Alberta Rizzuti, Giuseppe D'Agostino, Leandro Maria D'Auria, Maria Clara Pacilli, Jacopo Galli","doi":"10.14639/0392-100X-N2877","DOIUrl":"10.14639/0392-100X-N2877","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate the clinical relevance of absolute eosinophil blood count and eosinophil count by nasal cytology in the context of real-life clinical practice and to determine if they correlate with the severity of symptoms in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).</p><p><strong>Methods: </strong>We enrolled 425 patients with CRSwNP followed between January 2015 and April 2023 at the A. Gemelli Hospital Foundation-IRCCS, Rome, Italy. We gathered data on blood and local eosinophil count and correlated the results with clinical features. All patients underwent endoscopy, Visual Analogical Scale (VAS) for main symptoms, and SinoNasal Outcome Test 22 (SNOT-22).</p><p><strong>Results: </strong>We observed significantly higher mean levels of eosinophils in serum and at nasal cytology in patients with CRSwNP and comorbidities (asthma, non-steroidal anti-inflammatory drugs - exacerbated respiratory disease and allergy) compared to those without. Blood eosinophilia was not associated with severity of symptoms, whereas patients with nasal eosinophil count > 5 eosinophils per high-power field at nasal cytology had a significantly higher median specific VAS for nasal symptoms and significantly higher SNOT 22 scores.</p><p><strong>Conclusions: </strong>We demonstrated that blood eosinophil count and nasal cytology may represent useful tools in routine clinical practice to define Type 2 inflammation and that their levels are usually higher in patients with comorbidities. We also showed that blood eosinophilia was not correlated with severity of symptoms, whereas local eosinophil count was associated with high severity of symptoms and high burden on quality of life.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"45 1","pages":"39-46"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications in 2000 adult and paediatric cochlear implants: what to expect and when.","authors":"Vittoria Sykopetrites, Eleonora Sica, Flavia Di Maro, Eliana Cristofari","doi":"10.14639/0392-100X-N2778","DOIUrl":"10.14639/0392-100X-N2778","url":null,"abstract":"<p><strong>Objective: </strong>To identify the incidence of intra- and postoperative complications of adult and paediatric cochlear implants (CIs) in a large cohort with long follow-up.</p><p><strong>Methods: </strong>Retrospective chart analysis of 2000 consecutive cases of CI in a single institution.</p><p><strong>Results: </strong>8.9% of paediatric CIs developed a complication after a mean period of 5.5 ± 5.8 years. 12% of adult CIs developed a complication after a mean period of 3.5 ± 5.3 years.</p><p><p>Seroma was the most frequent paediatric complication (1.8%), after a mean of 8.9 ± 5.4 years, while vertigo was the most common complaint in adults (2.5%), emerging in the first year. Both complications were generally managed conservatively. Acute otitis media or abscess with extrusion of the receiver/stimulator required surgical revision, with or without CI explantation, in 23.5% and 76.9% of cases, respectively. Cholesteatoma or chronic otitis media were always treated surgically and required CI explantation in 86.7% of cases. All cases complicated by device failure (1.2% and 0.8% of paediatric and adult CIs, respectively) were treated with CI explantation and reimplantation, and emerged after a mean of 5 ± 4 years.</p><p><strong>Conclusions: </strong>Knowledge and decades long monitoring of the complications related to CIs are fundamental.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"45 1","pages":"58-69"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous neck haemorrhage secondary to parathyroid adenoma: description of a case and systematic review.","authors":"Alberto Vito Marcuzzo, Sara Fadda, Kevin Cargnelutti, Simone Zucchini, Lara Bigolin, Pierluigi Bonini, Giancarlo Tirelli","doi":"10.14639/0392-100X-N3055","DOIUrl":"10.14639/0392-100X-N3055","url":null,"abstract":"<p><strong>Introduction: </strong>Parathyroid adenomas can rarely cause spontaneous haemorrhage, which can be life-threatening. Diagnosis is challenging. We present a case and systematic review to define a clearer pattern of symptoms, diagnosis, and treatment.</p><p><strong>Materials and methods: </strong>We conducted a literature search of PubMed, Google Scholar, and Embase using PRISMA guidelines, identifying 38 relevant case reports on spontaneous neck bleeding or haematoma caused by parathyroid adenomas from 1974 to 2020. Data included epidemiology, clinical features, and treatment. One patient treated at our clinic is described.</p><p><strong>Results: </strong>Reviewing 38 articles, we found cervical haematomas from spontaneous bleeding of parathyroid adenoma in 45 patients, comprising 33 women and 12 men. Common symptoms were neck pain, dysphagia, and swelling. Surgery was the primary treatment, with 4.4% requiring tracheotomy. Average hospital stay was 12.5 days, which was mostly complication-free.</p><p><strong>Conclusions: </strong>Parathyroid adenoma haemorrhage in middle-aged women with neck swelling, pain, and swallowing difficulty should be suspected. Diagnosis involves blood tests and contrast CT. Treatment is adenoma removal, typically without major complications.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"45 1","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low condylectomy and functional therapy alone for unilateral condylar osteochondroma treatment: case report and literature review.","authors":"Domenico Sfondrini, Stefano Marelli, Rachele Patriarca, Sabino Luzzi, Giada Beltramini, Lorenzo Preda, Gabriele Savioli, Francesca Sfondrini","doi":"10.14639/0392-100X-N3119","DOIUrl":"https://doi.org/10.14639/0392-100X-N3119","url":null,"abstract":"<p><p>Osteochondroma (OC) is a common bone tumour that rarely affects the mandibular condylar process. This pathology can show typical clinical features, such as facial asymmetry, deviation of the chin and dental inferior midline, changes in condylar morphology and malocclusion with an increased posterior mandibular vertical height. The management of condylar OC is a debated topic among surgeons. Most of them combine systematically condylectomy with orthognathic surgery while only few others perform in the first instance only condylectomy followed by functional therapy. A case of a 32-year-old female diagnosed with a mandibular condylar OC successfully treated with condylectomy alone is presented. A literature review is carried out focusing on surgical management, clinical and imaging features, highlighting the differences between OC and other condylar growing lesions.</p><p><p>When maxillary alterations are not present or are mild as in the presented patient, the low condylectomy alone, followed by elastic functional therapy, can correct both the aesthetic and the occlusal disorders resulting from condylar OC removal. In case of severe dentoalveolar maxillary compensation, orthognatic surgery must be performed with the low condylectomy to quickly correct facial symmetry and occlusion.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"44 6","pages":"412-420"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maximising efficiency with exoscopic surgery: a versatile approach for transoral laryngeal and oropharyngeal procedures.","authors":"Filippo Marchi, Elisa Bellini, Alessandro Ioppi, Andrea Iandelli, Marta Filauro, Claudio Sampieri, Giampiero Parrinello, Andrea Laborai, Francesco Mora, Eolo Castello, Giorgio Peretti","doi":"10.14639/0392-100X-N2958","DOIUrl":"https://doi.org/10.14639/0392-100X-N2958","url":null,"abstract":"<p><strong>Objectives: </strong>Several devices have been developed to improve head and neck surgery. 3D exoscopes provide surgeons a viable alternative to microscopes. We propose our setting for transoral exoscopic oropharyngeal (TOEOS) and transoral exoscopic laryngeal surgery (TOELS).</p><p><strong>Methods: </strong>A case series of patients treated with the exoscopic setup at the Otolaryngology Unit of IRCCS San Martino Hospital, Genoa, is presented. Our surgical setup and surgical and oncological outcomes are described.</p><p><strong>Results: </strong>Among 40 patients undergoing TOELS for glottic and supraglottic tumours, negative superficial and deep margins were achieved in 79.2% and 75% of patients, respectively. The mean operative time was 73.7 ± 35.9 minutes. Fourteen patients were treated by TOEOS and in only one case was re-resection required due to a positive deep margin. The mean operative time for TOEOS was 140.3 ± 82.1 minutes and the average duration of hospitalisation was 10.3 ± 3.8 days.</p><p><strong>Conclusions: </strong>3D exoscopes improve visualisation of the surgical site in different environments and allow the use of multiple surgical instruments and lasers, easing transoral surgery. In addition, as the first surgeon's view is shared between the operatory room (OR) staff, the exoscopic setup plays a crucial role in the collaboration between the OR team and for teaching purposes.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"44 6","pages":"368-376"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142941546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of face protector devices on acoustic parameters of voice.","authors":"Valeria Caragli, Elisa Zacheo, Rosalba Nodari, Elisabetta Genovese, Antonio Mancuso, Laura Mazzoni","doi":"10.14639/0392-100X-N2851","DOIUrl":"https://doi.org/10.14639/0392-100X-N2851","url":null,"abstract":"<p><strong>Objectives: </strong>The SARS-CoV-2 pandemic required the use of personal protective equipment (PPE) in medical and social contexts to reduce exposure and prevent pathogen transmission. This study aims to analyse possible changes in voice and speech parameters with and without PPE.</p><p><strong>Methods: </strong>Speech samples using different types of PPE were obtained. Recordings were then analysed using PRAAT software (version 6.1.42). Statistical analysis was conducted using ANOVA in Jamovi software. A post-hoc test was performed to compare PPE-related results.</p><p><strong>Results: </strong>Statistically significant differences were found in Cepstral Peak of Prominence-Smoothed, Harmonic to Noise Ratio (HNR), slope of Long-Term Average Spectrum (LTAS), tilt of trendline through LTAS, shimmer parameters, HNR mean and standard deviation of vowels, vowels and consonants formants. HNR values increased whereas shimmer parameters and formant values reduced using PPE [PPE combined>filtering face piece (FFP)> surgical masks>no PPE].</p><p><strong>Conclusions: </strong>Our data show improvement in many parameters of voice and speech quality and modification of speech articulation when using masks, particularly in case of combined PPE. The most relevant changes were found with a combination of face shield and FFP2 masks. This may be due to unconscious improvements in speech articulation and increased demand on vocal folds to achieve better speech intelligibility.</p>","PeriodicalId":6890,"journal":{"name":"Acta Otorhinolaryngologica Italica","volume":"44 6","pages":"377-391"},"PeriodicalIF":2.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11706518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}