Annals of Plastic Surgery最新文献

{"title":"Upper Extremity Surgery in Hirayama Disease: A Modification of the Current Algorithm.","authors":"Elad Y Holzer, Tod A Clark, Jennifer L Giuffre","doi":"10.1097/SAP.0000000000004299","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004299","url":null,"abstract":"<p><strong>Introduction: </strong>Hirayama disease (HD) is a rare, nonfamilial, monomelic amyotrophy in which patients present with muscle atrophy and weakness of the forearms and hands, either unilateral or bilateral, and without sensory loss. Current treatment guidelines describe the role of conservative treatments including cervical collars and neurotropic medications, as well as spinal surgery in select patients. Upper extremity surgery has not yet been incorporated into the treatment algorithm of HD. The objective of this study is twofold: to present a case series of HD patients treated with the incorporation of nerve and tendon transfers and joint fusions into the existing treatment algorithm and to perform a literature review of interventions.</p><p><strong>Methods: </strong>Three cases (4 limbs) of HD treated surgically with nerve and tendon transfers and fusion are retrospectively reviewed. The subjective and objective results from surgery are reported. A literature review is performed on PubMed using \"Hirayama disease\" and \"peripheral nerve surgery,\" \"nerve transfer,\" \"tendon transfer,\" \"hand surgery,\" or \"upper extremity surgery\" as search terms to identify studies describing surgical treatment of HD outside of spinal surgery.</p><p><strong>Results: </strong>Three HD patients (4 limbs) were identified. The average age was 23 years old (range, 16-33 years). Patients presented with intrinsic muscle atrophy, hypothenar, and thenar atrophy. The disease had been present for an average of 6.5 years (range, 1.5-15 years) prior to referral. Two patients had unilateral involvement, whereas one had bilateral involvement. Two patients (3 limbs) were treated with an anterior interosseous (AIN) to ulnar motor nerve transfer, whereas a patient with delayed presentation underwent thumb metacarpophalangeal joint fusion and a Zancolli lasso to the fingers. All patients had subjective and objective improvements postoperation.The literature reveals three independent case reports of HD patients treated with upper extremity surgery. Two papers describe using a tendon transfer, whereas one paper describes an AIN to ulnar motor nerve transfer. All patients demonstrated functional improvements in follow-up.</p><p><strong>Conclusions: </strong>HD can be successfully treated with a combination of upper extremity surgery and nerve transfers. To the authors' knowledge, this is the first literature review and the largest case series presenting such interventions in HD.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 5","pages":"536-543"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974439","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":"Penis Reconstruction With Latissimus Dorsi Flap and Challenges for Penis Prosthesis in Phalloplasty.","authors":"Serdar Nasır","doi":"10.1097/SAP.0000000000004241","DOIUrl":"10.1097/SAP.0000000000004241","url":null,"abstract":"<p><strong>Background: </strong>Several methods of penile reconstruction have been described. Free flaps are considered the most functional and aesthetically appropriate treatment method. The main purpose of this reconstruction is to create the urinary tract and provide the most aesthetically similar structure to the biological penile tissue while also providing penile tissue of a size that will ensure adequate sexual intercourse.This method was investigated through a retrospective analysis of patients who underwent penile reconstruction with a latissimus dorsi free flap, which we believe provides all these features. Thirty patients who underwent surgery between 2020 and 2023 were included in the study group.</p><p><strong>Methodology: </strong>Latissimus dorsi flap is an important option for patients who need penile reconstruction, including those who want the donor site morbidity to be in a hidden area and those who have concerns about penis size.</p><p><strong>Result: </strong>Tissue of a size that provides sexual function and a structure in which a penile prosthesis can be easily inserted is obtained in patients who have undergone penile reconstruction with the latissimus dorsi. In addition, there was no problem in creating a glans penis or corona using this method. Pendular urethral reconstruction was not performed in this case series.</p><p><strong>Conclusions: </strong>We think that penile reconstruction with Latissimus dorsi, together with some of the modifications described, is one of the most functional and aesthetically appropriate methods.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"552-560"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456830","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":"Application of Wide, Adjustable External Traction Fixation in Conjunctival Approach Orbital Fat Reposition Surgery.","authors":"Huahui Zhang, Xiaohui Long, Guijuan He, Shengtao Weng","doi":"10.1097/SAP.0000000000004301","DOIUrl":"10.1097/SAP.0000000000004301","url":null,"abstract":"<p><strong>Background: </strong>The correction of tear trough deformities is a significant challenge. The aim of this study is to present a new technique of using wide, adjustable external traction fixation in conjunctival approach orbital fat reposition surgery.</p><p><strong>Methods: </strong>This is a retrospective case series study conducted on 69 patients, aged 18 to 45 years, who underwent surgery for palpebral bags and tear trough deformities (TTD) between October 2022 and March 2024. During surgery, wide, adjustable external traction fixation was used in conjunctival approach orbital fat reposition surgery. The modified Barton classification is used to evaluate the tear trough deformity preoperatively and postoperatively. Patient satisfaction and complication were evaluated.</p><p><strong>Results: </strong>Sixty-nine patients were enrolled in the study and completed the minimum follow-up period of 6 months. The mean follow-up period was 7.4 ± 1.2 months. There was a significant improvement in the grading of TTD before and after surgery, with an average preoperative TTD grade of 3.19 ± 0.69 and a postoperative grade of 0.84 ± 0.64 ( P < 0.001). No major complication was observed during the follow-up period.</p><p><strong>Conclusions: </strong>For patients with palpebral bags and tear trough deformities without significant skin laxity, transconjunctival orbital septum fat reposition surgery with wide, adjustable external traction fixation is a safe, stable, and effective surgical option and is worthy of broader adoption.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"516-520"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623281","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 Outcomes of Gender-Affirming Surgery in Individuals With Connective Tissue Disorders.","authors":"Jennifer K Shah, Justin M Camacho, Danielle Eble, Chandler Hinson, Daniel Najafali, Heli S Patel, Pin-Keng Shih, Rahim Nazerali, Shane D Morrison","doi":"10.1097/SAP.0000000000004237","DOIUrl":"10.1097/SAP.0000000000004237","url":null,"abstract":"<p><strong>Introduction: </strong>Gender-affirming surgery (GAS) is a complex process that often requires multiple surgical operations and carries a complication risk that could be exacerbated by connective tissue disorders (CTDs). This study aims to investigate the association between CTD diagnosis and GAS outcomes.</p><p><strong>Methods: </strong>Using the Merative MarketScan Research Databases, patients with gender dysphoria diagnoses who underwent GAS between 2007 and 2022 were identified. Among these, patients with diagnosed CTDs were identified. Demographics, comorbidities, and postoperative complications were recorded. Chi-squared, Shapiro-Wilk, Wilcoxon-Mann-Whitney, and multivariate logistic regression testing was used for statistical analysis.</p><p><strong>Results: </strong>Of 7575 patients meeting criteria (mean age 29 ±10 years), 300 (4%) had CTD diagnoses. One or more postoperative complications were recorded in 9.8% of patients, without statistically significant difference between CTD and non-CTD patients. Additional simultaneous GAS procedures [odds ratio (OR) 2.02; P < 0.01], Elixhauser index scores of 3+ (OR 1.36; P = 0.010), and age >45 years (OR 1.47; P = 0.02) increased odds of experiencing complications following the index GAS procedure, while CTD diagnoses ( P = 0.52) did not affect odds of experiencing complications. However, CTD diagnoses did elevate odds of readmission (OR 1.47; P = 0.046), as did multiple simultaneous GAS procedures (OR 2.66), Elixhauser index scores of 3+ (OR 3.72), and smoking (OR 2.18) ( P < 0.01).</p><p><strong>Conclusions: </strong>These findings suggest CTDs may impact some gender-affirming surgical outcomes, and careful preoperative evaluation and management of comorbidities is necessary to reduce the risk of complications and readmission in this population. Surgeons should continue to exercise caution when performing elective surgery on patients taking immunomodulatory medications.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"605-611"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188143","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":"14th Dedicated California Society of Plastic Surgeons Annals of Plastic Surgery Supplement.","authors":"Chris M Reid","doi":"10.1097/SAP.0000000000004332","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004332","url":null,"abstract":"","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 5S Suppl 3","pages":"S401-S402"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961501","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":"Progress With Shortcomings: An Examination of Demographic Representation in Integrated Plastic Surgery Residencies.","authors":"Miriam C Becker, Michael C Oca, Meera Reghunathan, Amanda A Gosman, Chris M Reid","doi":"10.1097/SAP.0000000000004222","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004222","url":null,"abstract":"<p><strong>Background: </strong>This retrospective study investigates progress in representation among Black, Hispanic, American Indian/Alaska Native (AIAN) Native Hawaiian/Pacific Islander (NHPI), and female demographics in plastic surgery and other surgical residencies. Utilizing applicant and resident data, demographic trends were examined to assess the effectiveness of recent diversification efforts.</p><p><strong>Methods: </strong>Binomial analysis of proportions applicants and residents between 2016 and 2022 was conducted. Instances where proportions of applicants surpassed that of residents indicated underrepresentation. Representation trends were assessed via linear regressions of proportions of applicants and residents with time as the explanatory variable. Binomial analysis of proportions of medical school graduates in 2020 and plastic surgery residents in 2021 was conducted. Instances where proportions of graduates surpassed that of residents indicated underrepresentation.</p><p><strong>Results: </strong>Plastic surgery saw an increase in female applicants (14.9%) and residents (5.5%), an increase in Hispanic residents from 2020-2022 (1.3%), and a decrease in AIAN (0.4%) and NHPI residents (0.2%). Black residents remained the most underrepresented group of residents relative to applicants. Trends were similar to those seen in other specialties. All groups were underrepresented in plastic surgery relative to numbers in the US population and among medical school graduates.</p><p><strong>Conclusions: </strong>Findings suggest that plastic surgery has made minimal progress in achieving representativeness relative to the US population. Although women and Hispanic demographics have made strides, similar progress has not been evident among Black, AIAN, and NHPI demographics. All groups continue to experience varying degrees of underrepresentation across specialties. Addressing this persistent disparity demands further investigation and targeted, strategic interventions.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 5S Suppl 3","pages":"S403-S411"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964160","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":"Response to Letter to Editor Regarding Long-Term Outcomes After Gender-Affirming Surgery: 40-Year Follow-up Study.","authors":"Rachel H Park, John T Stranix","doi":"10.1097/SAP.0000000000004236","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004236","url":null,"abstract":"","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 5","pages":"623"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954916","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":"Comparative Postoperative Complications of Acellular Dermal Matrix and Mesh Use in Prepectoral and Subpectoral One-Stage Direct to Implant Reconstruction: A Retrospective Cohort Study.","authors":"Michael Diffley, Amy Tang, Kinan Sawar, Tala Al-Saghir, Madeleine R Gonte, Jamie Hall, Donna Tepper, Vigen Darian, Maristella Evangelista, Dunya Atisha","doi":"10.1097/SAP.0000000000004233","DOIUrl":"10.1097/SAP.0000000000004233","url":null,"abstract":"<p><strong>Background: </strong>One-stage direct-to-implant (DTI) breast reconstruction is increasingly popular with the use of prepectoral reconstruction leading to increased demand for structural scaffolds. It is vital to determine if differences in safety profiles exist among scaffolds.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of consecutive patients in our breast cancer center undergoing DTI reconstruction. Outcomes relating to postoperative infections, wound complications, and implant related complications were extracted. Outcomes were grouped into major, minor, and long-term complications. Univariate and multivariate analysis determined outcome differences and accounted for confounding variables.</p><p><strong>Results: </strong>Two hundred forty-two patients (404 breasts) underwent DTI reconstruction. One hundred ninety-two breasts were reconstructed with FlexHD Pliable Preformed (PP; MTF Biologics, Edison, NJ), 122 with AlloDerm Ready To Use (RTU; Allergan Aesthetics, Irvine, CA), 22 with DermACELL (LifeNet Health, Virginia Beach, VA), 21 with Galaflex (Galatea Surgical, Lexington, MA), 22 with Meso BioMatrix (MTF Biologics), and 25 with autologous dermal flaps alone. Univariate analysis demonstrated statistically significant differences among scaffolds in the incidence of cellulitis treated with oral antibiotics, capsular contracture, explantation for capsular contracture, seroma requiring operative drainage, minor complications, and long-term complications. On multivariate regression, FlexHD PP had reduced rates of capsular contracture, explantation for capsular contracture, minor complications, and long-term complications compared to AlloDerm RTU. Reconstruction with Galaflex had increased rates of capsular contracture when compared to FlexHD PP.</p><p><strong>Conclusions: </strong>Certain structural scaffolds have differing safety profiles that should be considered when selecting, which product to use in DTI reconstruction.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"521-527"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057834","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 Obesity on Surgical Complications in Gender-Affirming Mastectomy: A Systematic Review and Meta-analysis.","authors":"Matthew F McLaughlin, Alexandra J Lopes, Nisha Parmeshwar, Peggy Tahir, Esther A Kim","doi":"10.1097/SAP.0000000000004365","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004365","url":null,"abstract":"<p><strong>Background: </strong>Body mass index (BMI) is sometimes used to determine surgical eligibility for gender-affirming mastectomy (GAM) but there is insufficient data informing these criteria. Given the limitations of single-institution studies, which lack the ability to generalize the potential impact of BMI on GAM complications across various surgical practices, a systematic review is needed.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was performed for all studies that evaluated the relationship between BMI and surgical outcomes after GAM. Our institution's GAM cohort (n = 457) was also included. Obesity was defined as BMI ≥ 30 kg/m2. The random-effects DerSimonian-Laird method was used to synthesize results across studies.</p><p><strong>Results: </strong>Of 605 studies screened, 10 met the inclusion criteria. There were a total of 1195 patients, of whom 441 (37%) were obese and 754 (63%) were nonobese. There were significantly higher odds of nipple-areola complex [odds ratio (OR) = 4.13, P = 0.04] and wound complications (OR = 4.27, P = 0.03) in patients with obesity compared to those without obesity. There were no significant differences in hematoma (OR = 1.16, P = 0.62), seroma (OR = 2.49, P = 0.14), or infection (OR = 1.63, P = 0.24).</p><p><strong>Conclusions: </strong>While some GAM complications were more common in patients with obesity, serious complications like hematoma and infection were as likely to occur among obese and nonobese patients. Patients with higher BMIs should be counseled about their increased risk for these complications. However, BMI cutoffs alone should not determine surgical eligibility, as these findings provide more generalizable evidence confirming the low morbidity associated with GAM.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109523","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":"The Impact of Women-Led Academic Collaborations in Plastic Surgery.","authors":"Tiffany Jeong, Nicolás M Kass, Hilary Y Liu, Angel Dixon, Nia Buckner, José Antonio Arellano, Vu T Nguyen, Francesco M Egro, Jesse A Goldstein, Carolyn De La Cruz","doi":"10.1097/SAP.0000000000004277","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004277","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Gender parity in overall academic productivity in plastic surgery has increased, likely driven by the greater proportion of women in plastic surgery residency. Given the crucial role of collaboration in research productivity and securing grant funding, it becomes imperative to investigate whether gender disparities affect collaboration for female authors in plastic surgery. In this study, we explore how gender influences academic collaboration among plastic surgeons, according to impact factor (IF), overall rates of collaboration, and the departments with which they collaborate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;PubMed was queried for all articles from academic plastic surgery programs between 2018 and 2023. Collaborative articles were defined as a plastic surgery senior author with at least one author who was not from the same plastic surgery department. The senior author affiliation was used to select articles from academic plastic surgery departments. The first and senior author's gender were determined using Gender-API, a validated approach to assigning gender based on first name. Associations with gender and research impact variables were assessed, including publishing journals and their IF. Gender predominance in a collaborating specialty was determined by the AAMC 2021 Physician Specialty Data Report.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 21,068 articles were initially retrieved, 14,590 articles were reviewed after removal of duplicates, and 6525 articles qualified for inclusion. Gender-API was able to identify 98% of authors as male or female. A total of 17.2% of publications were led by female authors and 38.3% had a female first author (χ2 = 691.21, P &lt; 0.0001). The proportions engaging in collaboration were similar, 18.3% and 37.9%, respectively. While female senior authors in plastic surgery have fewer publications (3.83 ± 7.31 vs 5.88 ± 11.1, P &lt; 0.001) we found that the average journal IF was significantly greater in female-led articles (3.84 ± 6.11 vs 3.35 ± 4.60, P = 0.009) than in male led articles.Female senior authors were more likely to publish collaborations with specialties that had a higher proportion of women (χ2 = 5.30, P = 0.021); for example, 2.86% (n = 1) of collaborations with cardiothoracic surgery were with women (odds ratio = 0.130, P = 0.0138) and 35.6% (n = 5) of collaborations with endocrinology were with women (odds ratio = 2.38, P = 0.155).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;We demonstrate the nuanced effect of collaboration on research productivity for female authors in plastic surgery. In particular, female plastic surgery senior authorship and overall collaboration coincides with the gender proportions in the field. Furthermore, female senior authors in plastic surgery published in significantly higher IF journals. Lastly, our work implies that female in-group networks of academic collaborations may serve a vital role in the professional connections for women in the pre","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 5S Suppl 3","pages":"S417-S420"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952789","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}