American Surgeon最新文献

{"title":"Core Needle Biopsy and Preoperative Risk Factors as Predictors of Upstaging Atypical Ductal Hyperplasia on Surgical Excision.","authors":"Rhea Rahim, Sarah Yuen, Mischa Esmail, Jordan Jackson, Marissa Boyle, Alice Chung, Catherine Dang, Scott Karlan, Armando Giuliano, Farin Amersi","doi":"10.1177/00031348261443327","DOIUrl":"10.1177/00031348261443327","url":null,"abstract":"<p><p>BackgroundPatients with atypical ductal hyperplasia (ADH) diagnosed on core needle biopsy (CNB) are recommended for surgical excision. However, the rate of upstaging to malignancy on final pathology varies widely. This study sought to determine the rate of upstaging for ADH diagnosed on CNB and to evaluate risk factors associated with upstaging.MethodsPatients diagnosed with ADH by CNB from 1/2014 to 9/2024 were identified from a prospectively maintained database. Pathology, imaging, demographics, family history of breast cancer, genetic testing, and risk of future malignancy were collected. Univariate and multivariable analysis were performed to evaluate predictors of upstaging.Results456 patients with ADH on CNB met inclusion criteria. Median age was 53 years (range 19-89 years). Overall, 110 (24.1%) patients were upstaged on surgical excision. The highest risk of upstaging was observed in patients with multifocal ADH (71.4%). Upstaged patients were older (<i>P</i> < .001), more likely to have a mammographic mass or architectural distortion (<i>P</i> = .03), abnormal MRI (<i>P</i> = .001), ADH bordering on DCIS or multifocal ADH on biopsy (<i>P</i> < .001). Multivariable analysis identified abnormal MRI as an independent predictor of higher risk (<i>P</i> = .046) and focal ADH as a predictor of lower upstage risk (<i>P</i> = .03). At a median follow-up of 52.5 months, 21 (4.6%) patients developed subsequent DCIS, and 20 (4.4%) patients developed subsequent invasive cancer.ConclusionADH on CNB was upstaged on surgical excision in 24.1% of patients. Multifocal ADH and abnormal MRI findings strongly predict upstaging to malignancy. The 9.6% rate of subsequent malignancy necessitates long-term surveillance for all patients with ADH.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2552-2557"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832466","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":"Infrahepatic IVC Resection and Prosthetic Reconstruction for Renal Cell Carcinoma.","authors":"Hanna D Sun, William J Lain, Patrick McCarthy, Behzad S Farivar","doi":"10.1177/00031348261457630","DOIUrl":"10.1177/00031348261457630","url":null,"abstract":"<p><p>Renal cell carcinoma (RCC) may result in venous tumor thrombus (VTT) extension into the inferior vena cava (IVC) in 4-36% of cases, with 20-25% requiring IVC resection or reconstruction. Here, we report a case of a 50-year-old man with right RCC and level II VTT who underwent radical nephrectomy and en bloc infrahepatic IVC resection for unexpected lateral wall invasion in the setting of clinically silent pulmonary tumor emboli (PTE). Despite the low embolic risk of level I-II thrombi (<3%), this patient presented with a significant burden of PTE. This case challenges the assumption that lower-level tumors as currently imaged and classified imply minimal risk of tumor embolism or venous wall invasion. Our experience underscores the necessity of pre-operative chest imaging to detect occult PTE, the limitations of imaging for assessing tumor vessel wall invasion, and the need to adequately prepare for unexpected circumstances when resecting RCC with VTT.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2661-2664"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052090","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":"Examining the Utility of Point-of-Care Capillary Hemoglobin Testing and Transfusion Decisions in the Trauma Bay.","authors":"Emily C Wee, Chloe K Cooper, Jeffry Nahmias, Cristobal Barrios","doi":"10.1177/00031348261448898","DOIUrl":"10.1177/00031348261448898","url":null,"abstract":"<p><p>BackgroundThis study evaluated a point-of-care capillary hemoglobin assay compared to physiologic indicators, such as systolic blood pressure (SBP), heart rate (HR), and Focused Assessment with Sonography in Trauma (FAST) imaging, in predicting transfusion outcomes for trauma patients.MethodsThis retrospective cohort study evaluated adult trauma patients presenting to a single Level I trauma center with an initial point-of-care capillary hemoglobin (POC-Hb; HemoCue®) obtained in the trauma bay. Patients were stratified by receipt of blood transfusion within 24 hours of arrival. Prehospital and emergency department vital signs, FAST results, transfusion timing, and volume were analyzed. Multivariable logistic regression identified variables independently associated with transfusion. Nonparametric tests (Mann-Whitney U, Kruskal-Wallis with post-hoc testing) and Spearman's rank correlation assessed associations between POC-Hb values and transfusion timing and volume.ResultsOf 1552 included patients, 552 received blood transfusions and had significantly lower POC-Hb values compared to non-transfused patients (11.5 vs 13.5 g/dL; <i>P</i> < 0.001). POC-Hb was not associated with transfusion on multivariable analysis, and showed no correlation with time to transfusion. Positive FAST results (OR 19.4, 95% CI 8.1-46.2, <i>P</i> < 0.001) and SBP on arrival (OR 48.5, 95% CI 15.0-156.7, <i>P</i> < 0.001) were associated with transfusion.ConclusionLower initial POC-Hb was associated with transfusion and weakly correlated with blood product volume on unadjusted analyses, but was not independently associated with transfusion or with time to transfusion after adjustment. SBP and FAST demonstrated stronger associations with transfusion outcomes and intensity. These findings support prioritizing physiologic indicators and FAST results over point-of-care hemoglobin when assessing transfusion need in trauma patients.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2720-2728"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832503","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":"Clinical Impact of Preoperative Sarcopenia on the Outcome of Patients With Right-Sided Colon Cancer.","authors":"Ergin Erginöz, Mahmut Alper Güldağ, Marika Nakashidze, Kevser Sak, Sefa Ergün, Server Sezgin Uludağ, Süleyman Demiryas, Kağan Zengin, Şebnem Batur, Nuray Kepil, Onur Tutar, Ender Dulundu","doi":"10.1177/00031348261450572","DOIUrl":"10.1177/00031348261450572","url":null,"abstract":"<p><p>IntroductionSarcopenia is recognized as a predictor of adverse outcomes in colorectal cancer, but evidence regarding its impact specifically in right-sided colon cancer remains limited. This study aimed to evaluate the prognostic significance of sarcopenia in patients undergoing colectomy for right-sided colon cancer.MethodsWe retrospectively analyzed 228 patients with right-sided colon adenocarcinoma who underwent curative-intent colectomy between 2016 and 2021 in a single institution. Sarcopenia was diagnosed using the psoas muscle index (PMI) on preoperative CT scans. Clinicopathologic variables, postoperative complications, overall survival (OS), and disease-free survival (DFS) were compared between sarcopenic and non-sarcopenic groups.ResultsAmong sarcopenic patients (34.2%), postoperative complications occurred in 46.2% compared with 23.3% of non-sarcopenic patients (<i>P</i> < .001). Sarcopenia was significantly associated with intra-abdominal infection (<i>P</i> = 0.040), pulmonary infection (<i>P</i> = .011), cardiac complications (<i>P</i> = .013), urinary tract infection (<i>P</i> = .013), and postoperative hypoalbuminemia (<i>P</i> < .022). Logistic regression identified postoperative hypoalbuminemia (<i>P</i> = .026) and prolonged hospital stay (<i>P</i> = .002) as independent predictors of complications. The 5-year OS was 19.7% in sarcopenic patients vs 43.0% in non-sarcopenic patients (<i>P</i> = .597), and 5-year DFS was 43.1% vs 51.7% (<i>P</i> = .154). Multivariate Cox analysis identified age ≥65 years (<i>P</i> = .015), male sex (<i>P</i> = .007), stage IV disease (<i>P</i> = .016), and elevated CEA (<i>P</i> = .021) as independent predictors of OS, and age ≥65 years (<i>P</i> = .046) and stage IV disease (<i>P</i> = .001) as independent predictors of DFS, while sarcopenia was not an independent predictor of either outcome.ConclusionSarcopenia was strongly associated with postoperative complications but not with OS or DFS. These findings suggest sarcopenia reflects perioperative risk rather than long-term prognosis in this subgroup.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2565-2575"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832494","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":"Cloud Computing Startup for Data Science- A Tutorial.","authors":"Andrew C Kuo, Lorenzo Hiraldo, Rachel L Wolansky, Joseph Sujka, Paul C Kuo","doi":"10.1177/00031348261433646","DOIUrl":"10.1177/00031348261433646","url":null,"abstract":"<p><p>Cloud computing has revolutionized analysis of large datasets. This tutorial provides a comprehensive, practical guide for research groups seeking to leverage cloud platforms for data analysis. The tutorial covers the foundations of cloud computing, including its history, rationale, and use cases for research, followed by detailed comparisons of the 3 major platforms: Google Cloud Platform (GCP), Amazon Web Services (AWS), and Microsoft Azure. Side-by-side comparisons of services, costs, ease of use, and selection guidelines assist researchers in choosing the most appropriate platform. A complete step-by-step example using hospital price transparency data demonstrates the entire workflow from account creation through results retrieval, enabling researchers to begin productive cloud-based analysis within hours.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2515-2522"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490307","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":"Law's Praxis-On Becoming Self-Actualized.","authors":"Timothy Nicholas Patselas","doi":"10.1177/00031348261457570","DOIUrl":"10.1177/00031348261457570","url":null,"abstract":"<p><p>The 12^th Invited Henry L. Laws lecture on Medical Education presented at the 94^th Southeastern Surgical Congress Meeting on February 22, 2026 entitled Law's Praxis-On Becoming Self-Actualized by Dr Timothy N. Patselas addresses how personal and professional qualities of Dr Laws can serve as guideposts to become fuller versions of ourselves. Examples of Dr Laws exceptional attributes are highlighted, followed by correlates from the author's personal and professional experience. Special attention is given to the author's journey with multiple sclerosis, and the impact chronic illness has made on his self-growth. Lastly, the author provides words of encouragement, resilience and hope in both the personal and professional domains.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2495-2500"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148158","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":"Age-Related Mortality in Trauma Patients Requiring Massive Transfusion.","authors":"Sophie Gonzalez, Andrew Maneval, Tejal Brahmbhatt, Daniel R Margulies, Galinos Barmparas, Yassar Hashim","doi":"10.1177/00031348261448887","DOIUrl":"10.1177/00031348261448887","url":null,"abstract":"<p><p>BackgroundMassive transfusion (MT) protocols improve survival in trauma patients. Elderly trauma patients requiring MT represent a high-risk population, yet outcome data remain limited. Understanding age-related differences is critical to guide resuscitation and resource allocation.ObjectiveTo characterize the association between MT and mortality in elderly vs younger trauma patients.ParticipantsTrauma patients at a Level I trauma center (1/2013-09/2024) who required MT (≥10 units of whole blood (WB) and/or packed red blood cells (pRBC) within 24 h) were included. Patients ≥65 (elderly) were compared to <65 (non-elderly). The primary outcome was 30-day mortality. Secondary outcomes included ICU and hospital length of stay (LOS), and ventilator days.ResultsOf 368 patients meeting inclusion criteria, 30 (8%) were elderly. Elderly patients were equally likely to be male (70% vs 83%, <i>P</i> = 0.06), but were significantly less likely to present with GCS ≤8 (20% vs 45%, <i>P</i> < 0.01) despite a significantly higher incidence of severe head trauma (AIS head >3 [53% vs 32%, <i>P</i> = 0.02]). There was no difference in median blood products transfused within the first 24 hours (23 vs 22 units, <i>P</i> = 0.95). Overall mortality was 51%, higher in elderly patients (73% vs 49%, <i>P</i> < 0.01), with shorter time to death (median 14 vs 34 days, <i>P</i> < 0.01). Adjusted Cox regression confirmed significantly higher adjusted mortality in the elderly (HR 1.25, <i>P</i> = 0.04).ConclusionElderly trauma patients requiring MT experience earlier and significantly higher mortality than younger patients, highlighting the need for improved risk stratification and tailored resuscitation strategies.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2744-2749"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147947220","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":"Postoperative Transthoracic Echocardiography Following Penetrating Cardiac Injury: Moving From Routine Use to a Risk-Stratified Approach.","authors":"Jane T French, Nicole T Lemon, Thomas J Capasso, Maryann I Mbaka, Nathan M Polite, Ryan T Deci, Steven G Miller, Christopher M Kinnard, Andrew C Bright, Ashley Y Williams, Jon D Simmons, Yann-Lei L Lee, Caroline Park, Charles C Butts","doi":"10.1177/00031348261461277","DOIUrl":"10.1177/00031348261461277","url":null,"abstract":"<p><p>BackgroundPatients undergoing surgical repair of penetrating cardiac injury are routinely evaluated postoperatively with a transthoracic echocardiogram (TTE). We hypothesized that patients undergoing a single operation for penetrating cardiac injuries without the need for cardiopulmonary bypass (CPB), coronary artery bypass grafting (CABG), or additional staged procedures do not benefit from routine postoperative TTEs.MethodsA retrospective chart review of patients presenting with cardiac injuries to a level I trauma center from January 2018 to March 2025 was performed. Patients with a blunt mechanism, age <18 years, or no identifiable penetrating cardiac injury were excluded. Demographic data, injury characteristics, postoperative care and complications, and TTE findings were analyzed.ResultsThirty-eight patients with penetrating cardiac injuries were identified. Twenty-one patients died within 4 hours of arrival, and 2 patients underwent advanced procedures (ie, CPB and CABG), leaving 15 patients for analysis. Thirteen (87%) were male with an average age of 36. The Median Injury Severity Score (ISS) was 26, with a median American Association for the Surgery of Trauma (AAST) heart injury grade of 3. Fourteen (93%) patients survived to discharge. Eight (53%) of the fifteen patients underwent postoperative TTEs, none of which revealed clinically significant findings relative to their procedure.DiscussionRoutine postoperative TTE demonstrated low clinical utility in this cohort. These findings support a selective approach to TTE based on injury complexity and clinical indicators. Postoperative TTE may be deferred in asymptomatic patients following uncomplicated repair but remains indicated in patients with new cardiac symptoms, higher-risk injury patterns, or complex operative repair.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2691-2696"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148275643","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":"Effect of Narrative-Based Palliative Care on Psychological Stress, Quality of Life, and End-of-Life Acceptance in Elderly Terminal Cancer Patients and Their Families.","authors":"Junhua Li, Linlin Zhou, Lijie Sun","doi":"10.1177/00031348261429443","DOIUrl":"10.1177/00031348261429443","url":null,"abstract":"<p><p>ObjectiveThis study aimed to preliminarily evaluate the impacts of narrative-based palliative care on psychological stress, end-of-life acceptance, and quality of life in elderly terminally ill cancer patients and their family caregivers.MethodsThis single-center, small-sample randomized controlled study enrolled 50 elderly terminal cancer patients. Patients were randomly assigned to either the observation group or the control group (n = 25 each). The observation group received narrative-based palliative care, while the control group received routine standard care. Family psychological stress was assessed using the Relative Stress Scale (RSS), and patients' perceived stress was evaluated with the Perceived Stress Scale-10 (PSS-10). Caregiver satisfaction was measured using a hospital-developed questionnaire. Patients' quality of life was evaluated using the SF-36, Chinese Version of the Death Attitude Profile (DAP-C), and Pittsburgh Sleep Quality Index (PSQI), respectively.ResultsBaseline characteristics did not differ significantly between the two groups (<i>P</i> > .05). Post-intervention, the observation group demonstrated significantly lower psychological stress among family members and higher caregiver satisfaction (<i>P</i> < .05). Patients in the observation group reported better quality of life, improved sleep, and greater acceptance of death than those in the control group (<i>P</i> < .05).ConclusionAs a small-sample, single-center study, these findings offer preliminary evidence that narrative-based palliative care may reduce psychological stress in elderly terminal cancer patients and caregivers while enhancing patients' quality of life, sleep quality, and acceptance of death. However, the limited sample size, single-site design, and narrow inclusion criteria restrict generalizability. Larger multicenter trials are needed to confirm these results.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2652-2660"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442131","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":"Immune-Inflammatory Markers Associated With Occult Appendiceal Neoplasms in Patients With Acute Appendicitis.","authors":"Nemanja Trifunović, Nebojša Mitrović, Jovana Trifunović, Marija Nikolić, Sara Filipović","doi":"10.1177/00031348261441671","DOIUrl":"10.1177/00031348261441671","url":null,"abstract":"<p><p>BackgroundAcute appendicitis ranges from mild inflammation to perforation. A clinically important subset of cases harbors an occult appendiceal neoplasm that is often indistinguishable from routine appendicitis preoperatively. Blood-derived inflammatory indices have been proposed as predictors of disease severity and malignancy. We evaluated the diagnostic value of platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and CRP/SII for predicting complicated appendicitis and identifying neoplasms.MethodsWe conducted a 5-year retrospective study of 837 appendectomies at a tertiary surgical center. Preoperative clinical, laboratory, imaging, and histopathologic findings were analyzed. Appendicitis severity was classified according to WSES criteria. Diagnostic performance was assessed using logistic regression and receiver-operating characteristic (ROC) analysis.ResultsAppendiceal neoplasms were found in 1.1% of patients and were uniformly unsuspected intraoperatively. Neoplastic patients were significantly older (<i>P</i> < 0.001) and had higher PLR and SII (<i>P</i> < 0.001 and <i>P</i> = 0.005). PLR (AUC 0.868) and SII (AUC 0.770) showed the strongest discrimination between benign and malignant pathology. CRP/SII showed the best performance for complicated appendicitis (AUC 0.703). Age, PLR, and CRP/SII were independent predictors of neoplasm, while SII, PLR, and CRP/SII were independently associated with complicated disease.DiscussionAppendiceal neoplasms may present as clinically uncomplicated appendicitis. Simple inflammatory indices-particularly PLR and SII-were associated with both disease severity and hidden malignancy. These inexpensive and widely available markers may support early surgical decision-making in older or high-risk patients. Prospective validation is needed to define optimal thresholds and refine their role in preoperative triage.</p>","PeriodicalId":7782,"journal":{"name":"American Surgeon","volume":" ","pages":"2713-2719"},"PeriodicalIF":1.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147643704","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}