American Journal of Otolaryngology最新文献

{"title":"Association of nasal surgery with olfactory function among older adults","authors":"Khamis T. Suleiman ,&nbsp;Richard G. Chiu ,&nbsp;Sharmilee M. Nyenhuis ,&nbsp;Kamal Eldeirawi ,&nbsp;Victoria S. Lee","doi":"10.1016/j.amjoto.2025.104638","DOIUrl":"10.1016/j.amjoto.2025.104638","url":null,"abstract":"<div><h3>Background/purpose</h3><div>Olfactory Dysfunction (OD) is a prevalent condition that commonly presents in the older adult population. Various factors have been shown to contribute to OD, such as neurodegenerative disease, older age, and smoking status; however, the influence of nasal surgery on olfactory function is not well delineated. This study seeks to explore the potential effect of nose surgery on olfactory function.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted on data for 2285 adults from Round 1 of the National Social Life, Health, and Aging Project (NSHAP), a nationally representative sample of US older adults. The 5-item Sniffin’ Sticks test was used to define olfactory function: correctly identifying <span><math><mo>≥</mo></math></span>4 odors indicated normal olfactory function, while correctly identifying 0–3 odors was considered OD Associations between prior nasal surgery and OD were assessed using multivariable logistic regression, and adjusted odds ratios (OR) were calculated. Analyses were weighted using NSHAP-provided person-level weights to account for sampling design.</div></div><div><h3>Results</h3><div>OD was present in 18.4 % of adults. The weighted average age was 67.1 ± 7.2 years among those with normal olfaction and 70.9 ± 7.9 years for those with OD. Of adults with OD, 9.8 % had a prior nasal surgery as compared to 8.1 % of those with normal olfaction, although the difference was not statistically significant. After adjusting for age, gender, race, education, prior stroke, dementia, and self-reported mental health, prior nasal surgery was not significantly associated with OD (OR: 1.14; 95 % CI: 0.77–1.70).</div></div><div><h3>Conclusion</h3><div>Prior nasal surgery was not associated with OD after controlling for covariates. While this study does provide unique insight into the relationship between nasal surgery and OD in nationally representative cohort of older adults, it was limited since the dataset utilized did not contain information on the specific surgery that participants underwent. Therefore, further research with more detailed information on the types of nasal surgeries and sinonasal conditions prior to surgery would further help elucidate the relationship between and nasal surgery and OD.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104638"},"PeriodicalIF":1.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reoperation for hematoma in patients on perioperative antithrombotic drugs underwent thyroidectomy","authors":"Bassam Abboud ,&nbsp;Christopher Abboud ,&nbsp;Mayssam Meouche","doi":"10.1016/j.amjoto.2025.104636","DOIUrl":"10.1016/j.amjoto.2025.104636","url":null,"abstract":"<div><h3>Backgrounds</h3><div>Evaluate the risk of reoperation for postoperative hematoma (POH) in patients on antithrombotic conditions underwent thyroidectomy.</div></div><div><h3>Methods</h3><div>Three groups: Groups 1, 2, and 3 included thyroidectomy without treatment, under antiplatelet and anticoagulation drugs, respectively. Occurrence of POH identified 2 groups: hematoma (Group A) and no hematoma (Group B).</div></div><div><h3>Results</h3><div>The overall incidence of POH was 6 %(reoperation 0.1 %, conservative 5.9 %). 83 % of the reoperation for POH occurred within the first 24 h. Antiplatelet and anticoagulant drugs were associated with a 3.4 and 5.2 increased odds of POH respectively. Hyperthyroidism, substernal goiter, hypertension, and antithrombotic drugs were present in 32 % and 7 %, 33 % and 11 %, 52 % and 27 %, and 30 % and 9 % of patients in groups A and B respectively. Reoperation was necessary in 0.08 %, 0.23 %, and 1 % of patients in groups 1, 2, and 3 respectively.</div></div><div><h3>Conclusions</h3><div>Patients underwent thyroidectomy under antithrombotic drugs are at much higher risk for reoperation for POH.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104636"},"PeriodicalIF":1.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of ChatGPT for patient education involving HPV-associated oropharyngeal cancer","authors":"Terral A. Patel ,&nbsp;Gillian Michaelson ,&nbsp;Zoey Morton ,&nbsp;Alexandria Harris ,&nbsp;Brandon Smith ,&nbsp;Richard Bourguillon ,&nbsp;Eric Wu ,&nbsp;Arturo Eguia ,&nbsp;Jessica H. Maxwell","doi":"10.1016/j.amjoto.2025.104642","DOIUrl":"10.1016/j.amjoto.2025.104642","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the ability of ChatGPT to generate reliably accurate responses to patient-based queries specifically regarding oropharyngeal squamous cell carcinoma (OPSCC) of the head and neck.</div></div><div><h3>Study design</h3><div>Retrospective review of published abstracts.</div></div><div><h3>Setting</h3><div>Publicly available generative artificial intelligence.</div></div><div><h3>Methods</h3><div>ChatGPT 3.5 (May 2024) was queried with a set of 30 questions pertaining to HPV-associated oropharyngeal cancer that the average patient may ask. This set of questions was queried a total of four times preceded by a different prompt. The answer prompts for each question set were reviewed and graded on a four-part Likert scale. A Flesch-Kincaid reading level was also calculated for each prompt.</div></div><div><h3>Results</h3><div>For all answer prompts (<em>n</em> = 120), 6.6 % were graded as mostly inaccurate, 7.5 % were graded as minorly inaccurate, 41.7 % were graded as accurate, and 44.2 % were graded as accurate and helpful. The average Flesch-Kincaid reading grade level was lowest for the responses without any prompt (11.77). Understandably, the highest grade levels were found in the physician-friend prompt (12.97). Of the 30 references, 25 (83.3 %) were found to be authentic published studies. Of the 25 authentic references, the answers accurately cited information found within the original source for 14 of the references (56 %).</div></div><div><h3>Conclusion</h3><div>ChatGPT was able to produce relatively accurate responses to example patient questions, but there was a high rate of false references. In addition, the reading level of the answer prompts was well above the Centers for Disease Control and Prevention (CDC) recommendations for the average patient.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104642"},"PeriodicalIF":1.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head and neck cancer trends in Ohio: Examining temporal, anatomical, and geospatial patterns across Appalachian and non-Appalachian regions","authors":"Samuel Borgemenke ,&nbsp;Milena Fabry ,&nbsp;Elizabeth A. Beverly","doi":"10.1016/j.amjoto.2025.104634","DOIUrl":"10.1016/j.amjoto.2025.104634","url":null,"abstract":"<div><h3>Purpose</h3><div>Head and neck cancer (HNC) is the seventh most common type of cancer worldwide. Compared to the rest of the United States, Appalachia has higher incidence rates of HNC. The purpose of this project is to examine the temporal, anatomical, and geospatial variances in head and neck cancers across Ohio, focusing on disparities between Appalachian and non-Appalachian regions.</div></div><div><h3>Methods</h3><div>Data was sourced from the Center for Disease Control and Prevention and Surveillance, Epidemiology, and End Results database. The incidence and mortality rates of HNC across Ohio were identified and sub classified based on anatomical site. Social determinants of health and environmental factors affecting HNC raters were compared between Appalachian and non-Appalachian regions.</div></div><div><h3>Results</h3><div>The incidence (<em>R</em> = 0.9, <em>P</em> &lt; 0.01) and mortality (<em>R</em> = 0.8, <em>P</em> &lt; 0.01) of head and neck cancer increased significantly from 1999 to 2021 and demonstrated a relationship with mortality (<em>R</em> = 0.3, <em>P</em> &lt; 0.01). Adult smoking (<em>R</em> = 0.5, <em>P</em> &lt; 0.001), obesity (R = 0.5, <em>P</em> &lt; 0.001), and dentist rates (R = 0.3, <em>P</em> &lt; 0.01) were associated with HNC rates. Mean mortality was significantly higher for Appalachian (mean = 10.7, SD = 2.6) than non-Appalachian (mean = 8.6, SD = 2.4) regions (<em>P</em> &lt; 0.01) communities.</div></div><div><h3>Conclusion</h3><div>These findings emphasize the importance of addressing modifiable risk factors through smoking cessation, weight management, and dietary improvements. The difference in mortality between Appalachian and non-Appalachian regions underscores the role of geographic and socioeconomic disparities in shaping health outcomes across Ohio.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104634"},"PeriodicalIF":1.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Goodbye Dr. Google, hello Dr. ChatGPT: Advancing a new frontier for ENT medical information online","authors":"Richard J. Lu ,&nbsp;Babak Azizzadeh","doi":"10.1016/j.amjoto.2025.104618","DOIUrl":"10.1016/j.amjoto.2025.104618","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104618"},"PeriodicalIF":1.8,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of ipsilateral false vocal fold resection on swallowing following transoral laser cordectomies — A fibreoptic endoscopic evaluation of swallowing study","authors":"A. Burián ,&nbsp;K. Smatanová ,&nbsp;T. Bocskai ,&nbsp;János Girán ,&nbsp;I. Szanyi","doi":"10.1016/j.amjoto.2025.104622","DOIUrl":"10.1016/j.amjoto.2025.104622","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate early and late impact of false vocal fold removal (vestibulectomy) on swallowing using FEES following type III, IV and V transoral laser cordectomies (TLC).</div></div><div><h3>Material and method</h3><div>Fifteen transorally resectable glottic cancers (10 T1a, 2 T1b, 2 T2, 1 selected T3) necessitating TLC with vestibulectomy were included. All participants underwent TLC in the investigation period. FEES was performed preoperatively and in the early and late postoperative period establishing modified penetration-aspiration scale (mPAS) and pharyngeal residue severity scale (PRSS) to statistically assess possible differences among the investigated timepoints. Laryngeal preservation and local recurrence were also noted.</div></div><div><h3>Results</h3><div>2 type III, 9 type IV, 2 type Va and 2 type Vd cordectomies were performed. Early postoperative mPASs changed significantly compared to preoperative status (<em>p</em> = 0.046). Difference between early and late postoperative mPASs was also significant (<em>p</em> = 0.046). There was no difference between preoperative and late postoperative mPASs (<em>p</em> = 1.0). Regarding pharyngeal residue, significant changes were noted in the early postoperative period compared to preoperative values (<em>p</em> = 0.002). Regarding late postoperative PRSSs, statistically significant decline was found compared to early postoperative scores (<em>p</em> = 0.004). No remarkable difference was found between preoperative and late postoperative PRSSs (<em>p</em> = 0.317). Laryngeal preservation failed in only one case due to recurrence.</div></div><div><h3>Conclusion</h3><div>In our serie, ipsilateral vestibulectomy during TLC did not deteriorate swallowing in the long term neither by increased pharyngeal residue nor by increased aspiration risk. Investigation of cases without co-morbidities may further confirm our observations. Nevertheless, TLC provided excellent laryngeal preservation.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104622"},"PeriodicalIF":1.8,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive surgery for hyperacusis-enhanced round and oval window reinforcement procedure","authors":"Herbert Silverstein,&nbsp;Neil Nayak,&nbsp;Sean Holmes,&nbsp;Allen Young,&nbsp;Kadie Nausha","doi":"10.1016/j.amjoto.2025.104615","DOIUrl":"10.1016/j.amjoto.2025.104615","url":null,"abstract":"<div><div>Hyperacusis is an audiological disorder in which patients become persistently sensitive and intolerant to everyday environmental sounds. Patients suffering from hyperacusis not only experience pain and discomfort, but also undergo impairments in social, occupational, recreational, and day-to-day activities, resulting in poor quality of life. Previously, a senior author (HS) reported a minimally invasive surgical technique to help hyperacusis patients via reinforcement of the oval and round windows with temporalis fascia (Silverstein, 2015). In a recent publication (Young, 2024), patients with (Loudness Discomfort Level) LDLs above 70 dB had an 80.1 % satisfaction with the round and oval window reinforcement and would recommend the surgery. However, in the group of patients whose LDLs were below 70 dB indicating extreme hyperacusis only 49 % were satisfied and would recommend the surgery. To improve the results, a modification of the original technique was used by enhancing the reinforcement in patients with severe hyperacusis. Enhanced reinforcement of the oval and round windows and tympanic membrane resulted in a superior reduction in hyperacusis symptoms.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104615"},"PeriodicalIF":1.8,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endonasal dome bind with incorporation of a columellar strut reduces Infratip fullness: a quantitative photographic analysis","authors":"Jeewanjot S. Grewal ,&nbsp;Michael Diffley ,&nbsp;Yitzchok Greenberg ,&nbsp;Suma Alzouhayli ,&nbsp;Kylie Springer ,&nbsp;Richard Westreich ,&nbsp;Robert H. Deeb","doi":"10.1016/j.amjoto.2025.104619","DOIUrl":"10.1016/j.amjoto.2025.104619","url":null,"abstract":"<div><h3>Objective</h3><div>To demonstrate the effectiveness of the dome bind suture technique with incorporation of a columellar strut in reducing infratip lobule fullness in closed rhinoplasty by use of quantitative photographic analysis.</div></div><div><h3>Methods</h3><div>A retrospective review of patients who underwent rhinoplasty by two senior authors was carried out. All surgical maneuvers were documented. Photographic analysis was performed quantitatively using Rhinobase software. Results were recorded as ratio of change relative to a stable anatomic reference. This was chosen as the intercanthal distance on frontal view and lateral canthus to lateral commissure distance on lateral view.</div></div><div><h3>Results</h3><div>Sixty-three patients were included who underwent the dome bind suture technique. On frontal view, the ratio of the infratip lobule on post-surgical images versus preintervention was 0.88, which represents a reduction of 12 % (<em>P</em> &lt; 0.01). This was not apparent on lateral view, with a postoperative/preoperative ratio of 1.02 (<em>P</em> = 0.53).</div></div><div><h3>Conclusion</h3><div>We have demonstrated that the endonasal dome bind technique with incorporation of a columellar strut is useful at reducing infratip lobule fullness on frontal view and is a valuable tool in the armamentarium of the rhinoplasty surgeon.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104619"},"PeriodicalIF":1.8,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trans-oral robotic surgery in the management of malignant oropharyngeal minor salivary gland tumors: A systematic review","authors":"Gian Marco Pace ,&nbsp;Camilla Zimello ,&nbsp;Andrea Costantino ,&nbsp;Elena Russo ,&nbsp;Antonella Polimeni ,&nbsp;Antonio Greco ,&nbsp;Giannicola Iannella ,&nbsp;Armando De Virgilio","doi":"10.1016/j.amjoto.2025.104616","DOIUrl":"10.1016/j.amjoto.2025.104616","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study is to evaluate trans-oral robotic surgery (TORS) in the treatment of oropharyngeal minor salivary glands (OPMSG) malignancies.</div></div><div><h3>Methods</h3><div>This study was performed according to the PRISMA statement. A systematic review was performed following a comprehensive electronic search in PubMed, Google Scholar and ScienceDirect databases for studies published until April 21st, 2024.</div></div><div><h3>Results</h3><div>Eleven studies were included in our analysis. A total of 180 patients (males: 44.8 %, <em>n</em> = 78/174) with a median age of 59.6 years (<em>n</em> = 174; IQR 53–72) who underwent OPMSG malignant tumor TORS resection were included. The most common histology was mucoepidermoid carcinoma (<em>n</em> = 76/161, 47.2 %), followed by adenoid cystic carcinoma (<em>n</em> = 42/161, 26.1 %) and polymorphous low-grade adenocarcinoma (n = 17/161, 10.6 %). 87.9 % of OPMSG were classified as T1-T2 (<em>n</em> = 153/174). The median hospitalization time was 4 days (<em>n</em> = 154; IQR 2–6.5). The median initiation of oral diet following surgery occurred on post-operative day 1 (n = 15; IQR 1–4). Post-operative complications, occurring within 30 days from the TORS procedure, presented in 5.8 % of cases (<em>n</em> = 10/172). Negative margins after resection of primary tumor were obtained in 80.4 % of cases (<em>n</em> = 139/173).</div></div><div><h3>Conclusions</h3><div>This systematic review confirms the safety and feasibility of TORS in the treatment of OPMSG malignancies. However, due to the low quality of included studies, further evidence is needed to establish clinical guidelines.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104616"},"PeriodicalIF":1.8,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A geographical comparison between head & neck cancer incidence and distribution of otolaryngologists","authors":"Henry C. Ideker ,&nbsp;Ahmad Odeh ,&nbsp;Angela Mazul ,&nbsp;Sean T. Massa","doi":"10.1016/j.amjoto.2025.104625","DOIUrl":"10.1016/j.amjoto.2025.104625","url":null,"abstract":"<div><h3>Objective</h3><div>The incidence of head and neck cancer (HNC) is increasing, and research is needed to identify and treat populations at higher risk.</div></div><div><h3>Methods</h3><div>The Surveillance, Epidemiology, and End Result (SEER), Area Health Resource File (AHRF), and American Community Survey (ACS) databases were queried for incidence of HNC, provider demographics, and county demographics, respectively. The primary outcome was county-level incidence rate. Multivariate analysis of county variables identified risk factors associated with higher incidence.</div></div><div><h3>Results</h3><div>The geographic incidence of HNC is unequally distributed with higher incidence in counties with older age (3.68 % increase, CI: 3.46–3.89 %), white (1.71 %, CI: 1.08–2.35 %) and black (1.20 %, CI: 0.40–2.00 %) race, and higher percentage of smokers (1.36 %, CI: 1.17–1.55 %). The otolaryngology workforce was inversely related to the county-level incidence. Compared to counties with no Otolaryngologist, those with 11+ had 41.5 % (39.7–43.4 %) lower incidence.</div></div><div><h3>Conclusion</h3><div>The otolaryngology workforce is not optimally distributed to address geospatial variation in HNC incidence.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104625"},"PeriodicalIF":1.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}