American Surgeon最新文献_第4页

Sustained Organ Preservation in Patients With Rectal Cancer After Sequential Short-Course Radiation Therapy and Chemotherapy. 连续短程放化疗后直肠癌患者器官的持续保存。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-11-01 Epub Date: 2025-05-08 DOI: 10.1177/00031348251341945

I-Chia Liu, Susan Gearhart, Chen Hu, Haniee Chung, Alodia Gabre-Kidan, Peter Najjar, Eric S Christenson, Nilofer S Azad, Valerie Lee, Atif Zaheer, Jacqueline E Birkness-Gartman, Amol K Narang, Jeffrey Meyer

{"title":"Sustained Organ Preservation in Patients With Rectal Cancer After Sequential Short-Course Radiation Therapy and Chemotherapy.","authors":"I-Chia Liu, Susan Gearhart, Chen Hu, Haniee Chung, Alodia Gabre-Kidan, Peter Najjar, Eric S Christenson, Nilofer S Azad, Valerie Lee, Atif Zaheer, Jacqueline E Birkness-Gartman, Amol K Narang, Jeffrey Meyer","doi":"10.1177/00031348251341945","DOIUrl":"10.1177/00031348251341945","url":null,"abstract":"BackgroundNonoperative management in patients with rectal cancer with complete response to radiation therapy and chemotherapy is of increasing interest. Most of the data on nonoperative management have centered around patients treated with long-course chemoradiotherapy. The ability of short-course radiation-based treatment courses to achieve durable complete responses with sustained organ preservation is less defined. This study updates our institution's long-term experience with nonoperative management following upfront short-course radiation therapy and sequential/consolidation chemotherapy.MethodsWe retrospectively reviewed patients with nonmetastatic rectal cancer treated with sequential short-course radiation therapy and chemotherapy who reached complete response and were subsequently followed with nonoperative management. We report on disease control outcomes, including rates of regrowth and results of salvage surgery. We investigated characteristics associated with local tumor regrowth.ResultsOur study included 52 patients. The 2-year freedom from local regrowth for the entire cohort was 75%. Notably, patients with high-risk disease characteristics at diagnosis exhibited a trend toward a higher rate of local tumor regrowth. No patient with sustained clinical complete response developed metastatic disease. Of the twelve patients undergoing surgical salvage for regrowth of disease, ten were resected with complete/near-complete total mesorectal surgical specimens with negative margins.ConclusionsThe optimal approach to achieving sustained organ preservation through the use of radiation therapy and chemotherapy is not well defined. Our findings show the viability of neoadjuvant therapy incorporating short-course radiation therapy to achieve durable complete responses.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1913-1922"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957417","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}

引用次数: 0

Long-Term Evaluation of Patients With Clinical Node-Negative Malignant Melanoma: A Tertiary Single Center Experience. 临床淋巴结阴性恶性黑色素瘤患者的长期评估：三级单中心经验。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-11-01 Epub Date: 2025-05-09 DOI: 10.1177/00031348251341962

Ugur Celik, Can Ege Yalcin, Fatih Cinar, Semih Baghaki, Yagmur Aydin

{"title":"Long-Term Evaluation of Patients With Clinical Node-Negative Malignant Melanoma: A Tertiary Single Center Experience.","authors":"Ugur Celik, Can Ege Yalcin, Fatih Cinar, Semih Baghaki, Yagmur Aydin","doi":"10.1177/00031348251341962","DOIUrl":"10.1177/00031348251341962","url":null,"abstract":"IntroductionWe aimed to investigate the prognostic factors for patients with cutaneous malignant melanoma undergoing sentinel lymph node biopsy.Materials and MethodsPatients who underwent sentinel lymph node biopsy between January 2004 and December 2019 were reviewed retrospectively. Demographic characteristics, tumor location, thickness and other histopathological features, number and status of lymph nodes removed in SLNB, results of elective lymph node dissection in SLNB-positive patients, distant and local metastases, mortality, and follow-up periods were recorded.ResultsThere were 222 patients, 96 females, with an age range of 54.25 ± 16.34 years. Mean tumor thickness was 3.65 ± 2.87 mm. Disease-free survival was calculated as 78.4 ± 56.79 months. Sixty-five patients (29.2%) had positive sentinel lymph node biopsies. Recurrence, defined as local, regional, or distant metastasis, mortality and mortality and/or recurrence was observed in 14.4%, 20.7% and 29.7% of patients, respectively. Sex, tumor thickness, presence of comorbidities, ulceration, and positive sentinel lymph nodes were found to be independent risk factors affecting mortality. Presence of ulceration and lymphatic invasion were independent risk factors for recurrence. Tumor thickness >2 mm led to a significantly shorter survival than the ones with tumor thickness <2 mm.ConclusionThe 5-year survival rate for malignant melanoma was found to be significantly higher in comparison to other studies in the literature. Additionally, acral lentiginous melanoma exhibited a significantly higher prevalence compared to nodular melanoma.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1906-1912"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952622","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}

引用次数: 0

The Efficacy of Half Purse Suture Technique in Eliminating "Dog-Ear" Deformity at Donor Site Incision in Deep Inferior Epigastric Perforator Flap (DIEP) Breast Reconstruction. 半袋缝合技术消除上腹部深下穿支皮瓣（DIEP）乳房再造术供区切口“狗耳”形畸形的疗效。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-11-01 Epub Date: 2025-07-03 DOI: 10.1177/00031348251354841

Xinle Wang, Liu Yang, Haoqi Wang, Meiqi Wang, Kaiye Du, Zhenchuan Song, Yuntao Li

{"title":"The Efficacy of Half Purse Suture Technique in Eliminating \"Dog-Ear\" Deformity at Donor Site Incision in Deep Inferior Epigastric Perforator Flap (DIEP) Breast Reconstruction.","authors":"Xinle Wang, Liu Yang, Haoqi Wang, Meiqi Wang, Kaiye Du, Zhenchuan Song, Yuntao Li","doi":"10.1177/00031348251354841","DOIUrl":"10.1177/00031348251354841","url":null,"abstract":"BackgroundTo evaluate the effectiveness of the half purse suture technique in eliminating the \"dog-ear\" deformity at the donor site incision of the Deep Inferior Epigastric Perforator flap (DIEP) for breast reconstruction.MethodFrom May to October 2022, the half purse suture technique was employed to suture the lateral ends of the donor site incision in 5 female patients undergoing DIEP breast reconstruction. The patients' ages ranged from 39 to 56 years, with a mean age of 48.2 years. Four patients underwent primary breast reconstruction, while one patient underwent secondary reconstruction. Postoperatively, the donor site on the abdomen was routinely dressed with compression bandages.ResultsAll 5 patients were followed up at one month postoperatively. The flaps survived successfully, and the donor site incisions healed primarily without complications. The skin at the lateral ends of the abdominal incisions appeared smooth, without any dog-ear deformity. No complications such as local concavity or infection were observed.ConclusionThe half purse suture technique effectively eliminates the \"dog-ear\" deformity at the donor site incision of the DIEP flap.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"1986-1990"},"PeriodicalIF":0.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558846","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}

引用次数: 0

Hansei (): The Surgeon's Quiet Reckoning. 韩生（）：外科医生的平静清算。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-10-09 DOI: 10.1177/00031348251385108

Javier Arredondo Montero

引用次数: 0

Impact of a Pediatric Appendicitis Clinical Pathway on Offering Non-operative Management. 小儿阑尾炎临床路径对提供非手术治疗的影响。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-10-09 DOI: 10.1177/00031348251385112

Margaret U Nguyen, Audrey D Kamzan, Alexandra Mv Klomhaus, Howard Ch Jen, Steven L Lee, Monette Gc Veral, Deepa D Kulkarni

{"title":"Impact of a Pediatric Appendicitis Clinical Pathway on Offering Non-operative Management.","authors":"Margaret U Nguyen, Audrey D Kamzan, Alexandra Mv Klomhaus, Howard Ch Jen, Steven L Lee, Monette Gc Veral, Deepa D Kulkarni","doi":"10.1177/00031348251385112","DOIUrl":"https://doi.org/10.1177/00031348251385112","url":null,"abstract":"BackgroundAppendicitis in children can be treated with operative management (OM) or non-operative management (NOM) depending on patient risk factors. Our goal was to evaluate for differences in being offered NOM before and after the implementation of a standardized clinical pathway among patients of different demographic backgrounds.MethodsThis was a single center retrospective study of patients under the age of 18 years with appendicitis. Univariate regression was used to assess for associations between demographic factors and patients who were offered NOM.ResultsThere were 730 unique patient encounters for appendicitis during the study period. Qualified patients had significantly increased odds of being offered NOM in the post-pathway period than in the pre-pathway period (OR = 2.21, 95th CI 1.28-3.82). In the post-pathway period, Hispanic/Latino patients (OR = 0.47, 95th CI 0.28-0.78) and patients in the 4th social vulnerability index quartile (OR = 0.46, 95th CI 0.23-0.94) had decreased odds of being offered NOM. Patients with private insurance (OR = 2.25, 95th CI 1.33-3.79) had increased odds of being offered NOM. When restricted to patients who qualified for NOM, female patients (OR = 2.66, 95th CI 1.02-6.93) and patients with private insurance (OR = 3.26 95th CI 1.31-8.15) were more likely to be offered NOM.ConclusionA clinical pathway for appendicitis increased the odds that qualified patients were offered NOM. However, differences in who was offered NOM based on demographic features were seen. More research on the effect of clinical pathways and factors impacting differential care is needed.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251385112"},"PeriodicalIF":0.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257182","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}

引用次数: 0

Effect of Primary Surgery on Health-Related Quality of Life in Metastatic Breast Cancer: A Systematic Review of RCT's. 原发性手术对转移性乳腺癌患者健康相关生活质量的影响：一项RCT的系统回顾

IF 0.9 4区医学

American Surgeon Pub Date : 2025-10-09 DOI: 10.1177/00031348251387153

Zoha Asghar, Zubaid Moazzam Sheikh, Kanza Sharaf, Muhammad Amaan Nadeem, Sheraz Ali, Luciano Mignini, Khalid S Khan

{"title":"Effect of Primary Surgery on Health-Related Quality of Life in Metastatic Breast Cancer: A Systematic Review of RCT's.","authors":"Zoha Asghar, Zubaid Moazzam Sheikh, Kanza Sharaf, Muhammad Amaan Nadeem, Sheraz Ali, Luciano Mignini, Khalid S Khan","doi":"10.1177/00031348251387153","DOIUrl":"https://doi.org/10.1177/00031348251387153","url":null,"abstract":"Background: Primary surgery in metastatic breast cancer (MBC) has been a subject of debate in part due to the heterogeneity of the results of individual studies. We synthesized evidence from the existing randomized clinical trials (RCTs) to evaluate the effect of primary surgery on health-related quality of life (HRQoL) in MBC. Methods: We searched PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar, and ClinicalTrials.gov and gray literature till January 2025. Included were RCTs among patients with MBC for whom outcome data on HRQOL was reported. Results: Of the 1019 records screened, four RCTs (961 patients) were included. The risk of bias was high in one RCT and moderate in three. Four HRQoL tools were deployed. Three moderate-quality RCTs measured HRQoL specifically at 18 months: One was in favor of surgery (BR23 18.7 vs. 10.0, P = 0.009), one showed no difference (BR23 10.4 vs. 12.0, P = 0.45), and one was in favor of avoiding surgery (FACT-B 74.2 vs. 68.0, P = 0.005). Two moderate-quality RCTs measured HRQoL generically at 18 months: None showed any difference (C30 64.7 vs. 60.0, P = 0.3 and C30 63.5 vs 68.7, P = 0.2). One low-quality RCT measured HRQoL generically at 36 months: It showed no difference (SF-12 40.8 vs. 43.4, P = 0.34). Primary surgery improved specific HRQoL at 18 months in one study and deteriorated in another, compared to non-surgical treatment, among moderate-quality trials. Conclusion: The pros and cons of surgery as a palliative option should be considered in shared decision-making for improving life quality among individual patients.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251387153"},"PeriodicalIF":0.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257155","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}

引用次数: 0

Guideline-Concordant Provision of Extended Prophylaxis for Venous Thromboembolism After Major Cancer Surgery Differs by Social and Structural Determinants of Health. 根据健康的社会和结构决定因素，对重大癌症手术后静脉血栓栓塞的延伸预防提供指南一致。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-10-08 DOI: 10.1177/00031348251385110

Alexander Booth, Jingwen Zhang, Justin E Marsden, Colleen Donahue, Thomas Curran

{"title":"Guideline-Concordant Provision of Extended Prophylaxis for Venous Thromboembolism After Major Cancer Surgery Differs by Social and Structural Determinants of Health.","authors":"Alexander Booth, Jingwen Zhang, Justin E Marsden, Colleen Donahue, Thomas Curran","doi":"10.1177/00031348251385110","DOIUrl":"https://doi.org/10.1177/00031348251385110","url":null,"abstract":"IntroductionPatients undergoing major cancer surgery face an increased risk of venous thromboembolism. Despite guidelines recommending extended pharmacologic prophylaxis for 30 days after surgery, adoption remains low. Differences in adherence to guidelines for extended prophylaxis based on social and structural determinants of health have not been examined, but if present, may contribute to observed disparities in cancer surgery outcomes.MethodsA single-center retrospective cohort study was performed to identify patients undergoing major gastrointestinal, gynecologic, or urologic cancer resections between 2014 and 2021. Extended prophylaxis was assessed via outpatient low molecular weight heparin prescriptions on hospital discharge and analyzed by demographic factors (age, sex, race, poverty status, and insurance), and procedural factors (organ category, surgical approach, and year) using chi-squared tests and multivariable logistic regression.ResultsOf 5246 patients, 17.1% received extended prophylaxis, varying by specialty. Extended prophylaxis was higher with increasing age, female sex, and Medicare or Medicaid insurance, but lower among below poverty level (14.3% vs 18.1%), Black (14.5% vs 18.2%), and minimally invasive surgery patients (7.9% vs 23.9%). Multivariable regression showed lower odds of receiving extended prophylaxis for below poverty level (adjusted odds ratio 0.73, 95% CI: 0.60-0.88) and Black patients (0.72, 95% CI: 0.58-0.89).DiscussionOverall utilization of extended prophylaxis is low (17.1%) while differences in use based on income and race suggest potentially modifiable factors related to social and structural determinants of health. A planned randomized trial (NCT6451003) will test patient and provider education interventions and a decision-support tool to improve guideline adherence and potentially address cancer disparities.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251385110"},"PeriodicalIF":0.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249367","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}

引用次数: 0

Optimal Timing of Surgical Intervention in Small Bowel Obstruction: A Systematic Review and Meta-Analysis of Clinical Outcomes and Risk Predictors. 小肠梗阻手术干预的最佳时机：临床结果和风险预测因素的系统回顾和荟萃分析。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-10-08 DOI: 10.1177/00031348251385103

Fahim Kanani, Nir Messer, Alaa Zahalka, Katia Dayan, Narmin Zoabi

{"title":"Optimal Timing of Surgical Intervention in Small Bowel Obstruction: A Systematic Review and Meta-Analysis of Clinical Outcomes and Risk Predictors.","authors":"Fahim Kanani, Nir Messer, Alaa Zahalka, Katia Dayan, Narmin Zoabi","doi":"10.1177/00031348251385103","DOIUrl":"https://doi.org/10.1177/00031348251385103","url":null,"abstract":"Optimal timing for surgical intervention in small bowel obstruction remains controversial, with traditional guidelines recommending 48-72 h of conservative management before considering surgery. We conducted a systematic review and meta-analysis to determine whether early surgical intervention improves clinical outcomes and to identify predictors of failed conservative management. We searched PubMed, Embase, Cochrane Library, and Web of Science from January 2010 to October 2024 for studies comparing surgical timing in adults with small bowel obstruction. Primary outcomes included mortality, bowel resection rates, and complications. Random-effects models were used to calculate pooled risk ratios and odds ratios with 95% confidence intervals. Among 47 studies comprising 12 486 patients, early surgery within 24 h significantly reduced mortality (RR 0.53, 95% CI 0.34-0.82, P = 0.004), bowel resection rates (RR 0.56, 95% CI 0.43-0.73, P < 0.001), and overall complications (RR 0.62, 95% CI 0.48-0.79, P < 0.001) compared to delayed intervention. Time-stratified analysis revealed a progressive increase in complications from 18% at less than 6 h to 52% beyond 48 h (P < 0.001). Conservative management succeeded in 73% of patients overall. Significant predictors of failure included absence of flatus (OR 3.3), fever (OR 2.8), complete obstruction (OR 4.1), and free fluid on CT (OR 3.7). A risk score combining three or more factors predicted failure with 84% sensitivity and 78% specificity. This meta-analysis provides robust evidence that early surgical intervention within 24 h significantly improves outcomes in appropriately selected patients with small bowel obstruction. Risk stratification using clinical and radiological predictors enables individualized decision-making rather than adherence to arbitrary waiting periods.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251385103"},"PeriodicalIF":0.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249380","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}

引用次数: 0

Hepatojejunostomy for Treatment of Challenging Persistent Bile Leak After Blunt Liver Trauma. 肝空肠吻合术治疗钝性肝外伤后顽固性胆汁漏。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-10-08 DOI: 10.1177/00031348251385101

Yunus Sür, Arif Atay, Ceren Yavuz, Osman Nuri Dilek

引用次数: 0

Whistal Procedure: A Single Institution Case Series and Literature Review. 举报程序：单一机构个案系列及文献回顾。

IF 0.9 4区医学

American Surgeon Pub Date : 2025-10-08 DOI: 10.1177/00031348251385111

Sibi Krishna Thiyagarajan, Shalyn Fullerton, Alfredo Verastegui, Katherine Poruk, John A Stauffer

{"title":"Whistal Procedure: A Single Institution Case Series and Literature Review.","authors":"Sibi Krishna Thiyagarajan, Shalyn Fullerton, Alfredo Verastegui, Katherine Poruk, John A Stauffer","doi":"10.1177/00031348251385111","DOIUrl":"https://doi.org/10.1177/00031348251385111","url":null,"abstract":"BackgroundWhistal (Whipple + Distal) is a rare parenchyma-preserving technique for select patients with disease in both the pancreatic head and tail, sparing a disease-free middle segment. It may also be used after prior partial pancreatectomy. Surgical resection remains the cornerstone of treatment for pancreatic diseases such as PDAC, RCC metastasis, and multifocal IPMN. Whistal may balance oncologic control with pancreatic function preservation. Though infrequent, it is practiced and reported in literature.MethodsWith IRB approval, a retrospective review of a prospective database (Aug 1999-Mar 2024) identified Whistal cases, categorized as staged Whistal (SW) or concomitant whistal (CW). Perioperative outcomes were assessed via Clavien-Dindo and ISGPS. A PubMed search identified reported middle segment pancreatectomy (Whistal) cases.ResultsOf 2008 resections (Aug 1999-Mar 2024), 5 were Whistals (3 CW, 2 SW) for PDAC (n = 3), RCC (n = 1), IPMN (n = 1), and bile duct stricture (n = 1). Rates for major morbidity, POPF, and DGE were each 40%. Literature review found 26 papers reporting 52 additional Whistal cases.ConclusionWhistal is safe for select patients, but wider adoption and long-term data are needed to confirm its efficacy.","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"31348251385111"},"PeriodicalIF":0.9,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243643","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}

引用次数: 0