Advances in wound care最新文献

{"title":"Acellular Adipose Matrices Seem to Be an Effective and Safe Strategy for Soft Tissue Regeneration and Volume Restoration: A Systematic Review of Clinically Relevant Literature.","authors":"Manaav K S Mehta, Hanna E Englander, Ajay Rao, Nicholas Jarostchuk, Giorgio Giatsidis","doi":"10.1089/wound.2024.0076","DOIUrl":"https://doi.org/10.1089/wound.2024.0076","url":null,"abstract":"<p><p><b>Significance:</b> Autologous adipose tissue grafting (AAG) can provide soft tissue reconstruction in congenital defects, traumatic injuries, cancer care, or cosmetic procedures; over 94,000 AAG procedures are performed in the United States every year. Despite its effectiveness, the efficiency of AAG is limited by unpredictable adipocyte survival, impacting graft volume retention (26-83%). <b>Recent Advances:</b> Acellular adipose matrices (AAMs) have emerged as a potential alternative to AAG. AAMs include adipose tissue-derived extracellular matrix (ECM) and growth factors (GFs), but not cells. When grafted, AAMs serve as scaffolds with biochemical and biophysical cues for local cell (especially adipocytes) proliferation, regenerating soft tissue, and restoring volume. Being acellular, the AAM is not limited by adipocyte necrosis/apoptosis. <b>Critical Issues:</b> Research on AAM has mostly been conducted on small animal models and with small grafts. Clinically relevant AAM research (large animal models and/or clinical trials) is sparse and limited. To address this gap, we conducted a systematic review of clinically relevant AAM literature to assess AAM's clinical efficacy and safety. Across 11 human and 1 porcine study involving reconstructive or cosmetic procedures, we found that AAMs resulted in significant volume retention, adipogenesis, and angiogenesis, without notable adverse effects. <b>Future Directions:</b> Available quantitative and qualitative data suggest that AAM is an effective and safe alternative to AAG. Yet, the current literature is still limited; more robustly designed studies with standardized methods to assess outcomes will help validate these positive preliminary findings, and possibly pave the way for a broader clinical adoption of AAM.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969260","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":"Improved Wound Healing by Direct Cold Atmospheric Plasma Once or Twice a Week: A Randomized Controlled Trial on Chronic Venous Leg Ulcers.","authors":"Olaf Bakker, Paulien Smits, Chantal van Weersch, Melissa Quaaden, Esther Bruls, Angela van Loon, Joost van der Kleij","doi":"10.1089/wound.2023.0196","DOIUrl":"10.1089/wound.2023.0196","url":null,"abstract":"<p><p><b>Objective:</b> This study compared the effect of two frequencies of direct cold atmospheric plasma (direct-CAP) treatment with standard of care (SOC) alone on healing of venous leg ulcers (VLUs). <b>Approach:</b> Open-label, randomized controlled trial (ClinicalTrials.gov NCT04922463) on chronic VLUs at two home care organizations in the Netherlands. All three groups received SOC for 12 weeks or until healing. In addition, treatment groups received direct-CAP once (1× direct-CAP) or twice (2× direct-CAP) a week, at specialized wound care facilities and the patients' residences. Primary outcome was percentage of wounds healed. Secondary outcomes included wound area reduction and adverse events. <b>Results:</b> In total, 46 patients were randomly allocated to receive SOC only (<i>n</i> = 15), SOC + direct-CAP once a week (<i>n</i> = 17), or SOC + direct-CAP twice a week (<i>n</i> = 14). A higher percentage of wounds healed within 12 weeks in the treatment groups 53.3% (1× direct-CAP, <i>p</i> = 0.16) and 61.5% (2× direct-CAP, <i>p</i> = 0.08) versus 25.0% (control). The largest wound area reduction was obtained with 2× direct-CAP (95.2%, <i>p</i> = 0.07), followed by 1× direct-CAP (63.9%, <i>p</i> = 0.58), versus control (52.8%). Absolute wound area reduced significantly compared with baseline in both treatment groups (<i>p</i> ≤ 0.001), not in control (<i>p</i> = 0.11). No device-related serious adverse events occurred. <b>Innovation:</b> Direct-CAP applied once or twice a week could substantially improve wound healing of VLUs in primary care. <b>Conclusion:</b> Together with other clinical safety and efficacy data, these results support the integration of direct-CAP as a valuable therapy for complex wounds.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"1-13"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140846826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pathophysiology and Management of Pathologic Scarring-a Contemporary Review.","authors":"Sophia G Hameedi, Angela Saulsbery, Oluyinka O Olutoye","doi":"10.1089/wound.2023.0185","DOIUrl":"10.1089/wound.2023.0185","url":null,"abstract":"<p><p><b>Significance:</b> Pathologic scarring occurs secondary to imbalances in the cellular mechanisms of wound healing and affects millions of people annually. This review article aims to provide a concise overview of the pathophysiology and management of pathologic scarring for clinicians and scientists alike. <b>Recent Advances:</b> Contemporary research in the field has identified aberrations in transforming growth factor-β/small mothers against decapentaplegic (TGF-β/SMAD) signaling pathways as key drivers of pathologic scar formation; indeed, this pathway is targeted by many treatment modalities and translational investigations currently underway. Although intralesional injection of corticosteroids has been the gold standard in the treatment of pathologic scarring, studies show greater treatment efficacy with the use of combination injections such as triamcinolone/5-fluorouracil and triamcinolone/botulinum toxin. Adjunctive therapies including ablative fractional carbon dioxide/erbium-doped yttrium aluminum garnet and non-ablative pulsed-dye lasers, microneedling, and carboxytherapy have shown encouraging results in small cohort studies. Translational investigations involving the use of nanogels, RNA interference, and small molecules targeting TGF-β/SMAD pathways are also currently underway and hold promise for the future. <b>Critical Issues:</b> The heterogeneous nature of hypertrophic scars and keloids poses significant challenges in formulating standardized treatment and assessment protocols, thereby limiting the conclusions that can be drawn. <b>Future Directions:</b> Rigorous clinical trials into the individual and synergistic effects of these therapies would be ideal before any definitive conclusions or evidence-based treatment recommendations can be made. Owing to the heterogeneity of the pathology and patient population, well-conducted cohort studies may be the next best option.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"48-64"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140304373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Negative Pressure Wound Therapy: Challenges, Novel Techniques, and Future Perspectives.","authors":"Corey Keenan, Noor Obaidi, Jamie Neelon, Irene Yau, Anders H Carlsson, Kristo Nuutila","doi":"10.1089/wound.2023.0157","DOIUrl":"10.1089/wound.2023.0157","url":null,"abstract":"<p><p><b>Significance:</b> Negative pressure wound therapy (NPWT) has been in practice for decades, proving its utility in many applications, ranging from acutely infected wounds to complex combat wounds and skin grafting. It has been routinely demonstrated that NPWT has superior wound healing outcomes compared with previous standard-of-care therapies. However, the technique involves some challenges related to each of the components that comprise the therapy. The purpose of this article is to highlight the challenges, introduce the recent advancements, and discuss about the future directions in NPWT systems. <b>Recent Advances:</b> New techniques and materials have been developed to improve the currently used NPWT systems with promising results when utilized with appropriate indications. Many advancements have been introduced in modes of negative pressure delivery, pumps, interface dressings, adhesive dressings, and tubing technology. <b>Critical Issues:</b> An optimal NPWT system would avoid the common problems such as failure to deliver negative pressure due to loss of an airtight seal or tissue ingrowth into the interface dressing causing painful dressing changes and bleeding. Other challenges include infection control and patient pain and discomfort that may contribute to noncompliance. <b>Future Directions:</b> Many studies have been performed to evaluate the optimal combination of settings and components in various wounds; however, there is still no clear \"best\" answer for many specific patient-wound scenarios. Novel and emerging tissue engineering and regenerative medicine approaches could potentially be utilized in the future NPWT systems and thus, this review will discuss some novel ideas for future considerations.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"33-47"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140027175","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":"Acknowledgment of Reviewers 2024.","authors":"","doi":"10.1089/wound.2024.74523.revack","DOIUrl":"https://doi.org/10.1089/wound.2024.74523.revack","url":null,"abstract":"","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":"14 1","pages":"65-66"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982447","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":"Local Treatment of Wound Infections: A Review of Clinical Trials from 2013 to 2024.","authors":"David Larson, Jamie Neelon, S L Rajasekhar Karna, Kristo Nuutila","doi":"10.1089/wound.2024.0129","DOIUrl":"10.1089/wound.2024.0129","url":null,"abstract":"<p><p><b>Significance:</b> Management of infection is a critical aspect of wound care. It involves the application of various interventions to treat the wound and prevent the infection from spreading to other parts of the body, which may lead to serious complications, including sepsis. Local treatment of skin wound infections is the favored route of administration, reducing the risk of adverse systemic effects while providing very high therapeutic concentrations at the target site. The purpose of this article was to review clinical trials from 2013 and onward, focusing on local treatment of acute wounds and burns as well as chronic wounds as their primary outcome measurement. <b>Recent Advances:</b> Based on our literature search, 49 clinical trials were focusing on treating infected chronic wounds, and 6 trials studied infection as their primary outcome in acute wounds during the last 10 years. <b>Critical Issues:</b> Currently commercially available local treatments do not prevent the onset of invasive infection. Therefore, there is a need for more effective local therapies. <b>Future Directions:</b> Despite multiple preclinical studies introducing novel and promising strategies in terms of novel antimicrobial agents and delivery methods to prevent and treat skin wound infections locally, many have yet to be tested in a clinical setting. These preclinically tested approaches could still be valuable additions to today's care of infected skin wounds.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"14-32"},"PeriodicalIF":5.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142611753","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":"Smoking Status Impacts Mitochondrial Function and Synthetic Function in Mesenchymal Stem Cells Derived from Diabetics with Arterial Insufficiency.","authors":"Dylan McLaughlin, Maiko Sasaki, Carson Hoffmann, Luke Brewster, Katherine E Hekman","doi":"10.1089/wound.2024.0075","DOIUrl":"https://doi.org/10.1089/wound.2024.0075","url":null,"abstract":"<p><p><b>Objective:</b> Diabetes and smoking are frequently co-morbid conditions leading to arterial insufficiency, significantly increasing the risk of non-healing wounds and subsequent major amputation. Autologous patient-specific mesenchymal stem cells (MSCs) present a novel tool for regenerative therapy to treat advanced stages of arterial insufficiency. The regenerative performance of cells from diabetics with impaired arterial perfusion is known to be reduced, but the impact of additional patient factors such as smoking remains poorly understood. <b>Approach:</b> MSCs were harvested from amputees under IRB approval. Mitochondria were evaluated for mitophagy and bioenergetic function. MSC growth, reactive oxygen species (ROS), and synthetic function were measured. Exogenous nicotine was used to mimic smoking byproducts. Data were analyzed by one-way analysis of variance with <i>p</i> < 0.05 considered statistically significant. <b>Results:</b> Four MSC patient lines were from smokers and four were from non-smokers. All were male, diabetic, and matched for age. Mitochondrial turnover, ROS production, proliferation, and doubling time were comparable between groups. Smoking status significantly decreased glycolytic capacity, maximal mitochondrial respiration, and the synthetic function of MSCs compared with non-smokers (<i>p</i> < 0.05). Acute nicotine exposure in non-smoker MSCs significantly increased mitochondrial function, an effect that incompletely resolved with nicotine withdrawal (<i>p</i> < 0.001). <b>Innovation:</b> This study implicates mitochondrial dysfunction in smoking-mediated impairment of MSC synthetic function. <b>Conclusion:</b> Smoking alters mitochondrial bioenergetics and synthetic function of MSCs from diabetic patients with arterial insufficiency. Restoring mitochondrial function may improve synthetic function and therapeutic capabilities of smoker MSCs. Targeted rejuvenation strategies may be required based on smoking status for autologous MSC therapies for patients with arterial insufficiency.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":""},"PeriodicalIF":5.8,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870972","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":"Use of Acellular Matrices as Scaffolds in Cartilage Regeneration: A Systematic Review.","authors":"Wolfram Demmer, Jannik Schinacher, Paul Severin Wiggenhauser, Riccardo E Giunta","doi":"10.1089/wound.2024.0065","DOIUrl":"10.1089/wound.2024.0065","url":null,"abstract":"<p><p><b>Significance:</b> Cartilage regeneration remains a significant challenge in the field of regenerative medicine. Acellular matrix (AM)-based cartilage tissue regeneration offers an innovative approach to repairing cartilage defects by providing a scaffold for new tissue growth. Its significance lies in its potential to restore joint function, mitigate pain, and improve the quality of life for patients suffering from cartilage-related injuries and conditions. <b>Recent Advances:</b> Recent advances in AM-based cartilage regeneration have focused on enhancing scaffold properties for improved cell adhesion, proliferation, and differentiation. Moreover, several scaffold techniques such as combining acellular dermal matrix (ADM) and acellular cartilage matrix (ACM) with cartilage tissue, as well as biphasic scaffolding, enjoy rising research activity. Incorporating bioactive factors and advanced manufacturing techniques holds promise for producing more biomimetic scaffolds, advancing efficient cartilage repair and regeneration. <b>Critical Issues:</b> Obstacles in AM-based cartilage regeneration include achieving proper integration with the surrounding tissue and ensuring long-term durability of the regenerated cartilage. Furthermore, issues such as high costs and limited availability of suitable cells for scaffold seeding must be considered. The heterogeneity and limited regenerative capabilities of cartilage need to be addressed for successful clinical translation. <b>Future Directions:</b> Research should focus on exploring advanced biomaterials and developing new techniques, regarding easily reproducible scaffolds, ideally constructed from clinically validated and readily available commercial products. Findings underline the potential of AM-based approaches, especially the rising exploration of tissue-derived ADM and ACM. In future, the primary objective should not only be the regeneration of small cartilage defects but rather focus on fully regenerating a joint or larger cartilage defect.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"625-638"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141074925","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":"Testosterone Promotes Nerve Tethering and Acellular Biomaterial Perineural Fibrosis in a Rat Wound Repair Model.","authors":"Calvin R Schuster, Erik Reiche, Patrick R Keller, Sophia Hu, Vance Soares, Siti Rahmayanti, Visakha Suresh, Thomas G W Harris, Joshua C Doloff, Sami Tuffaha, Devin Coon","doi":"10.1089/wound.2024.0043","DOIUrl":"10.1089/wound.2024.0043","url":null,"abstract":"<p><p><b>Objective:</b> Nerve scarring after traumatic or iatrogenic exposure can lead to impaired function and pain. Nerve-adjacent biomaterials promoting a regenerative tissue response may help reduce perineural fibrosis. Our prior work suggests that testosterone may promote fibrotic skin scarring, but it is unknown how testosterone alters nerve fibrosis or shifts the response to biomaterials. <b>Approach:</b> Sterilized Lewis rats received either testosterone cypionate (+T) or placebo (-T) biweekly. Fifteen days later, wounds were created over the sciatic nerve and covered with an acellular matrix (AM) or closed via primary closure (PC). At day 42, force gauge testing measured the force required to mobilize the nerve, and wound tissue was analyzed. <b>Results:</b> Nerve mobilization force was greater in +T versus -T wounds (<i>p</i> < 0.01). Nerves tore before gliding in 60% of +T versus 6% of -T rats. Epidermal gap (<i>p</i> < 0.01), scar width (<i>p</i> < 0.01), and cross-sectional scar tissue area (<i>p</i> = 0.02) were greater in +T versus -T rats. +T versus -T rats expressed less <i>Col-3</i> (<i>p</i> = 0.02) and <i>CD68</i> (<i>p</i> = 0.02). Nerve mobilization force trended nonsignificantly higher for PC versus AM wounds and for +T versus -T wounds within the AM cohort. <b>Innovation:</b> Testosterone increases nerve tethering in the wound healing milieu, altering repair and immune cell balances. <b>Conclusion:</b> Testosterone significantly increases the force required to mobilize nerves in wound beds and elevates histological markers of scarring, suggesting that testosterone-induced inflammation may increase perineural adhesion. Testosterone may reduce the potential anti-tethering protective effect of AM. Androgen receptor antagonism may represent a therapeutic target to reduce scar-related nerve morbidity.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"615-624"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141074873","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":"Nanosheet Promotes Chronic Wound Healing by Localizing Uncultured Stromal Vascular Fraction Cells.","authors":"Shimpo Aoki, Yori Endo, Cynthia Guo, Mengfan Wu, Audrey Kim, Megumi Takuma, Jessica Mroueh, Luisa Weber, Toshinori Fujie, Kristo Nuutila, Indranil Sinha","doi":"10.1089/wound.2024.0014","DOIUrl":"10.1089/wound.2024.0014","url":null,"abstract":"<p><p><b>Objective:</b> To develop an efficacious and efficient method for treating chronic wounds using \"nanosheet\" that improves the survival and localization of transplanted cells without prior seeding to optimally derive the regenerative potentials of uncultured stromal vascular fraction (SVF) cells. <b>Approach:</b> We propose a method whereby the wound is covered by uncultured SVF cells using the nanosheet [porous poly(d, l,-lactic acid)] (PDLLA) films) designed to hold cells in a single-cell layer. A chronic wound model was created on 12-month-old db/db mice by inflecting a full-thickness skin excision on their dorsum and was subsequently given either no treatment or a treatment with SVF cells alone (with Tegaderm dressing), nanosheet alone, or nanosheet with SVF cells. <b>Results:</b> The placement of the nanosheet improved the grafted cell retention rate at day 10 timepoint by 5 folds, and the wound area was the smallest in the wounds treated with SVF cells plus nanosheet in comparison to the other groups. Collagen deposition and epidermal growth factor were significantly higher in the wound beds treated with SVF cells with the nanosheet, offering some mechanistic insights. <b>Innovation:</b> Porous poly(d, l,-lactic acid acid) (PDLLA) films or \"nanosheet\" printed on the nanoscale (1-100 nm in thickness) as a cellular scaffold for cytotherapy for the treatment of chronic wounds. <b>Conclusion:</b> The use of the nanosheet is an effective way to improve the transplanted SVF cell retention and accelerate the overall wound closure.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":" ","pages":"601-614"},"PeriodicalIF":5.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179050","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}