Advances in wound care最新文献

{"title":"Epidemiological Trends of Pressure Injuries at the Global, Regional, and National Levels: A Trend Analysis Study from 1990 to 2021.","authors":"Hao Yang, Yuxi Zhou, Honglin Wu, Yongfei Chen, Xiaohui Li, Peng Wang, Jiayuan Zhu, Zhicheng Hu, Shuting Li","doi":"10.1089/wound.2025.0003","DOIUrl":"https://doi.org/10.1089/wound.2025.0003","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate global, regional, and national trends in the prevalence and disability-adjusted life years (DALYs) of pressure injuries (PIs) from 1990 to 2021 and project future trends to 2035, based on data from the Global Burden of Disease (GBD) study. <b>Approach:</b> This study used GBD 2021 data to analyze PIs prevalence and DALYs by age, sex, and Sociodemographic Index (SDI) region. The Bayesian age-period-cohort model was employed for temporal trend analysis and future projections. <b>Results:</b> From 1990 to 2021, the global prevalence slightly decreased from 8.246 to 7.920 per 100,000 (estimated annual percentage change -0.023%), whereas DALYs decreased by 9.7%. High-SDI regions presented significant DALY reductions (-39.3%), whereas middle- and low-middle-SDI regions presented increased prevalence rates (20.5% and 28.9%, respectively). The prevalence was highest in the ageing population, peaking in the 95+ year age group. Projections estimate that there will be 720,660 global cases by 2035, with the greatest burden expected among older adults in developing regions. <b>Innovation:</b> This study provides a comprehensive longitudinal analysis of PIs, revealing global disparities and emphasizing demographic-specific risks, especially in ageing populations and low-SDI regions. Bayesian modeling offered robust future projections. <b>Conclusion:</b> Despite modest improvements globally, significant disparities in the prevalence of PIs persist, particularly in developing regions and among older adults. Targeted interventions, preventive strategies, and health care policies are critical for addressing these challenges and mitigating future disease burdens.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300956","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":"Pressure Injury Incidence and Quality of Care Index (1990-2021): An Analysis of Trends and Health Inequalities Based on the Study of Global Burden of Disease 2021.","authors":"Zhi-Qin Xie, Xue-Mei Tao, Ze-Quan Wang, Yun-Yu Du, Lin-Xia Yi, Chao Xie, Han-Xiao Yi, Min Zhang, Wan-Yin Xiong, Shi-Han Chen, Chao-Zhu He, Rui Liu, Li Zhou, Zhen Yang","doi":"10.1089/wound.2024.0241","DOIUrl":"https://doi.org/10.1089/wound.2024.0241","url":null,"abstract":"<p><p><b>Objectives:</b> To elucidate the global disease burden and care quality associated with pressure injury (PI). <b>Approach:</b> This study examined temporal trends in PI incidence over the past 32 years. Decomposition analysis attributed these trends to demographic and epidemiological shifts, and cross-national health inequities were quantified. The Quality of Care Index (QCI) was constructed using principal component analysis to assess spatiotemporal variations in global PI care quality. A log-linear age-period-cohort model was employed to forecast trends over the next 15 years. <b>Results:</b> In 2021, there were nearly 2.47 million PI cases globally, a 115.92% increase from 1.14 million in 1990. Decomposition analysis revealed that population aging and demographic growth were the primary drivers of increasing PI incidence. Lower QCI was concentrated in African countries and those with low sociodemographic index (SDI). Incidence rates increased gradually with improving SDI. Significant health inequalities existed among 204 countries and regions, with minimal changes in inequality slope indices over time. Projections indicate a gradual increase to 3.5 million PI cases globally by 2035. <b>Innovation:</b> This study developed a novel comprehensive indicator, the QCI, and for the first time, shed light on health inequalities in PI across 204 countries and territories. <b>Conclusion:</b> Over the past 32 years, the global disease burden of PI has been significant, accompanied by health inequalities across countries and regions. For nations with low SDI, there remains considerable room for improvement in the quality of care for PI, necessitating more effective strategies to address health care disparities.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245727","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":"Clinical Practice Guidelines for the Prevention and Management of Pressure Injury in Critically Ill Patients Undergoing Prone Position Ventilation: A Systematic Review.","authors":"Ya-Bin Zhang, Chun-Yan Han, Dan Ma, Rui Li, Ai-Bing Si, Shui-Yu Wang","doi":"10.1089/wound.2024.0239","DOIUrl":"https://doi.org/10.1089/wound.2024.0239","url":null,"abstract":"<p><p><b>Significance:</b> This systematic review was conducted to assess the quality of clinical practice guidelines (CPGs) on prevention and management of pressure injury (PI) in patients undergoing prone position ventilation (PPV) and summarize the recommendations based on the analyses of the CPGs. <b>Recent Advances:</b> We searched the PubMed, Cochrane library, Embase databases, guideline websites, professional association, quality standards, and Wound-Related Research Journals from January 1, 2010 to August 31, 2024. Included guidelines were those with recommendations for prevention and management of PI in patients undergoing PPV published in English. Four researchers independently assessed the eligible studies and extracted the data. Appraisal of Guidelines Research & Evaluation (AGREE II) instrument and the Reporting Items for Practice Guidelines in Healthcare checklist were used to assess the quality of the CPGs. <b>Critical Issues:</b> A total of 13 CPGs were included in this review. AGREE II demonstrated that the highest mean score was based on the scope and purpose and was 73.65 ± 10.91, whereas the lowest mean score was based on the editorial independence and was 49.79 ± 19.49. The scores of inter-rater agreements for AGREE-II quality appraisal ranged from 0.86 to 0.96. Recommendations for prevention and management of PI in patients undergoing PPV were inconsistent. <b>Future Directions:</b> The included CPGs were limited due to methodological issues and exhibited discrepancies in the coverage of important topics. Therefore, existing evidence should be used to propose identifiable recommendations and strengthen the rigor and standardization of guideline development in future research.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232933","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":"Clinical Measurement of Transepidermal Water Loss.","authors":"Dibyasankha Kundu, Anant Jayaraman, Chandan K Sen","doi":"10.1089/wound.2024.0148","DOIUrl":"10.1089/wound.2024.0148","url":null,"abstract":"<p><p><b>Significance:</b> Recent reports recognize transepidermal water loss (TEWL) as a critical objective parameter measuring clinical wound healing endpoint. At the site of wound repair, TEWL measures functional wound closure as marked by re-establishment of barrier function at the wound site. This review article addresses recent developments in clinical TEWL measurement in the context of human skin health and wound care. To that end, emphasis is placed on the review of registered clinical studies reported in ClinicalTrials.gov for which TEWL results have been posted or published. <b>Recent Advances:</b> The U.S. Food and Drug Administration (FDA) defines complete wound closure as the achievement of 100% re-epithelialization of the wound surface, with no detectable exudate, drainage, or need for wound dressing, as verified during two sequential clinical assessments conducted at least 14 days apart. Clinically, wounds may meet this current FDA-recommended clinical criteria for wound closure, yet not achieve functional wound closure which requires the re-establishment of barrier function at the site of repair. Such wounds are likely to recur. High TEWL posthealing predicts wound recurrence. Thus, TEWL measurement at the site of repair posthealing is emerging as a significant measurement of wound healing endpoint. <b>Critical Issues:</b> Appropriate clinical measurement of TEWL requires a basic understanding of the related technologies and their appropriate use. Such understanding will help achieve the necessary rigor and reproducibility in clinical measurement. <b>Future Directions:</b> Recent reports on the critical significance of TEWL in wound care open new horizons wherein TEWL is likely to have broader applications involving altered skin barrier functions, such as during aging and other factors that determine skin health. Evidence to support revisiting the FDA definition of wound closure to include restoration of barrier function at the site of closure is strong. Widespread adoption of TEWL in wound care practices to determine functional wound closure is anticipated.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232932","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 Association Between Risk-Adjusted Wound Healing Rates and Long-Term Outcomes in a Network of U.S. Wound Care Clinics.","authors":"Grigory Franguridi, Andrew Becker, Soeren Mattke, Mary Sheridan, Jack Knott, William Ennis","doi":"10.1089/wound.2024.0263","DOIUrl":"https://doi.org/10.1089/wound.2024.0263","url":null,"abstract":"<p><p><b>Objective:</b> Chronic wounds have a high prevalence and poor outcomes in a geriatric population. It is unknown whether higher rates of successful wound healing are associated with better long-term outcomes. We sought to determine the association of risk-adjusted healing rates in wound care clinics with postdischarge outcomes. <b>Approach:</b> This observational study compared outcomes of Medicare patients with chronic wounds who received care at clinics with the highest risk-adjusted wound healing rates (<i>n</i> = 91) to those with the lowest rates (<i>n</i> = 88) in a network of 510 specialized U.S. wound care clinics. All 12,703 patients with chronic wounds at the clinics that could be identified in Medicare data were included. The outcomes were incidences of wound recurrence, gangrene, sepsis, and amputation after discharge. <b>Results:</b> The study included 6,462 and 6,241 patients in top- and bottom-performing clinics, respectively. Being treated in a top-performing clinic was associated with a lower cumulative incidence of all four outcomes. The difference was statistically significantly lower for wound recurrence (adjusted hazard ratio [aHR] = 0.82, 95% confidence interval [CI] 0.76-0.87, <i>p</i> < 0.001) and gangrene (aHR = 0.62, 95% CI 0.52-0.76, <i>p</i> < 0.001) but not for sepsis (aHR = 0.88, 95% CI 0.76-1.001, <i>p</i> = 0.065) and amputation (aHR = 0.75, 95% CI 0.65-1.00, <i>p</i> = 0.055). <b>Innovation:</b> This study is the first to suggest that patients treated in clinics with better wound-healing outcomes also have better outcomes after discharge. This finding can inform analyses to understand differences in practice patterns that lead to better outcomes. <b>Conclusion:</b> Treatment of chronic wounds in wound care clinics with higher risk-adjusted healing rates is associated with a lower risk of wound-related adverse events during follow-up, particularly in the first year. More research is needed to understand the factors that contribute to this effect and to determine interventions to improve outcomes sustainably as well as assess the impact of changes in outcomes on resource utilization and patients' quality of life.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223995","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":"Current State of Science in Negative Pressure Wound Therapy.","authors":"Stéphanie F Bernatchez","doi":"10.1089/wound.2024.0180","DOIUrl":"10.1089/wound.2024.0180","url":null,"abstract":"<p><p><b>Significance:</b> Negative pressure wound therapy (NPWT) was introduced in clinical practice in the early 1990s and has become widely used to manage wounds in inpatient and outpatient care. <b>Recent Advances:</b> Evolutions of the initial technology include the development of new dressing interfaces and tubing configurations, the addition of instillation to improve cleansing, and various changes in design to improve portability. Research has been conducted to understand mechanisms of action and to demonstrate clinical utility. NPWT has been suggested as a valuable approach for various complex and/or nonhealing wounds, and recommendations for its use have emerged in several guidelines. <b>Future Directions:</b> The evidence, composed of a combination of randomized controlled trials, case series, cohort studies, real-world evidence, systematic reviews, meta-analyses, and expert opinion, is heterogeneous and still building. This special mini forum issue presents the current state of the science for NPWT and new studies providing insights on some innovative ways clinicians use this technology to help improve outcomes in a variety of wound types.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"273-278"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575026","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":"Assessment of Patient-Reported Outcomes for Closed-Incision Negative Pressure Therapy with Wide-Coverage Dressings in Simple Mastectomy and Immediate Implant-Based Breast Reconstruction.","authors":"Benjamin G Baker, Andrew Pieri","doi":"10.1089/wound.2023.0116","DOIUrl":"10.1089/wound.2023.0116","url":null,"abstract":"<p><p><b>Objective:</b> A new configuration of closed-incision negative pressure therapy (ciNPT) dressings now covers the incision and a broader area of peri-incisional tissues. We have implemented these ciNPT dressings following simple mastectomy (SM) or skin-sparing mastectomy with implant-based reconstruction (IBR). This study assesses patient-reported outcomes of this new protocol. <b>Approach:</b> Patients underwent SM or IBR for breast cancer. ciNPT with wide-coverage dressings were placed over the entire breast, and -125 mmHg was applied for 14 days. Upon dressing removal, patients rated their experience using the Wound-Q™ Suction Device Scale and recorded their satisfaction on a Likert scale ranging 1-5. <b>Results:</b> Thirteen SM patients and 12 IBR patients were included in the study. The median age was 62 years, and SM patients were significantly older (<i>p</i> < 0.01). Patients rated the ciNPT device highest on items relating to its function and appearance, and lowest on noise and interference with sleep and physical activity. The overall mean score for the combined cohort was 64.8/100. The mean score for SM patients (74.8 ± 19.9) was significantly greater than for IBR patients (53.9 ± 9.6, <i>p</i> < 0.01). The mean overall patient satisfaction rating was 3.92 on a 5-point scale; 4.0 in the SM group and 3.8 in the IBR group. <b>Innovation:</b> This study is the first to report on the patient experience with these newly available wide-coverage ciNPT dressings. <b>Conclusion:</b> Overall, the dressing was well-tolerated by patients, and satisfaction was high. The positive reception of ciNPT with wide-coverage dressings supports continued use at our hospital.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"279-284"},"PeriodicalIF":5.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848365","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":"Comparative Analysis of Animal Models in Wound Healing Research and the Utility for Humanized Mice Models.","authors":"Haley Cirka, Tammy T Nguyen","doi":"10.1089/wound.2024.0082","DOIUrl":"https://doi.org/10.1089/wound.2024.0082","url":null,"abstract":"<p><p><b>Significance:</b> The rise of chronic nonhealing lower extremity wounds among aging, diabetic, obese, and cardiovascular patients has surged. Despite a decade of drug testing in preclinical animal models, few federally approved therapies have emerged. This translational gap raises concerns about the efficacy of current wound healing models and the need for improved research development. <b>Recent Advances:</b> To improve commonly used animal models of chronic wounds, researchers have made several animal model modifications to better mimic and understand the microbiota and immune-mediated wound healing processes that occur in humans. <b>Critical Issues:</b> Existing models do not fully account for the differences in skin architecture, healing processes, and immune system responses in wound healing between animal models and humans. Therefore, it is imperative to understand the limitations of a chosen model when designing experiments. As such, findings must be interpreted cautiously and validated in human contexts. <b>Future Directions:</b> Given the complexity of human wound healing, the use of several different animal models tailored to specific biological questions is necessary. Recent advancement in humanized mouse models and microbiota consideration offer a promising approach to study the human immune-mediated response in chronic wound healing.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141276","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":"SEMTWIST Quantification of Biofilm Infection in Human Chronic Wound Using Scanning Electron Microscopy and Machine Learning.","authors":"Surabhi Singh, Fabio Muniz De Oliveira, Cong Wang, Manoj Kumar, Yi Xuan, Deeptankar DeMazumder, Chandan K Sen, Sashwati Roy","doi":"10.1089/wound.2024.0291","DOIUrl":"10.1089/wound.2024.0291","url":null,"abstract":"<p><p><b>Objective:</b> To develop scanning electron microscopy-based Trainable Weka (Waikato Environment for Knowledge Analysis) Intelligent Segmentation Technology (SEMTWIST), an open-source software tool, for structural detection and rigorous quantification of wound biofilm aggregates in complex human wound tissue matrix. <b>Approach:</b> SEMTWIST model was standardized to quantify biofilm infection (BFI) abundance in 240 distinct SEM images from 60 human chronic wound-edge biospecimens (four technical replicates of each specimen). Results from SEMTWIST were compared against human expert assessments and the gold standard for molecular BFI detection, that is, peptide nucleic acid fluorescence <i>in situ</i> hybridization (PNA-FISH). <b>Results:</b> Correlation and Bland-Altman plot demonstrated a robust correlation (<i>r</i> = 0.82, <i>p</i> < 0.01), with a mean bias of 1.25, and 95% limit of agreement ranging from -43.40 to 47.11, between SEMTWIST result and the average scores assigned by trained human experts. While interexpert variability highlighted potential bias in manual assessments, SEMTWIST provided consistent results. Bacterial culture detected infection but not biofilm aggregates. Whereas the wheat germ agglutinin staining exhibited nonspecific staining of host tissue components and failed to provide a specific identification of BFI. The molecular identification of biofilm aggregates using PNA-FISH was comparable with SEMTWIST, highlighting the robustness of the developed approach. <b>Innovation:</b> This study introduces a novel approach \"SEMTWIST\" for in-depth analysis and precise differentiation of biofilm aggregates from host tissue elements, enabling accurate quantification of BFI in chronic wound SEM images. <b>Conclusion:</b> Open-source SEMTWIST offers a reliable and robust framework for standardized quantification of BFI burden in human chronic wound-edge tissues, supporting clinical diagnosis and guiding treatment.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959104","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":"Acellular Scaffolds for Muscle Regeneration: Advances and Challenges.","authors":"Jessica Mroueh, Luisa Weber, Yori Endo, Vanessa Mroueh, Indranil Sinha","doi":"10.1089/wound.2024.0049","DOIUrl":"https://doi.org/10.1089/wound.2024.0049","url":null,"abstract":"<p><p><b>Significance:</b> Volumetric muscle loss is defined as composite loss of muscle mass. Severe injuries result in permanent functional impairment. Treatment options are limited. Tissue engineering techniques utilizing scaffolds offer promise as a potential therapy. <b>Recent Advances:</b> Emerging strategies, including bioactive molecules and growth factors in biocompatible scaffolds, may promote muscle regeneration following severe injury. In this context, scaffolds can act as a drug-delivery device, provide guidance to cells as a supporting matrix, and slowly release growth factors to promote healing. <b>Critical Issues:</b> Scaffolds engraftment and ability to promote tissue regeneration in injured beds remain limited. Tuning and optimizing scaffold fiber diameter, alignment, cellular cues, growth factor delivery, and porosity will be important in reconstituting functional skeletal muscle following loss. <b>Future Directions:</b> Our mechanistic understanding of interactions between biomimetic scaffolds and host tissue is still evolving, and future research can identify factors to promote tissue regeneration.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958034","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}