Annals of Plastic Surgery最新文献

{"title":"Thirty-Day Complication Rates After Gender-Affirming Bottom Surgery: An Analysis of the NSQIP Database From 2010 to 2020.","authors":"Jennifer Goldman, Anna Hu, Adam Hammer, Yagiz Matthew Akiska, Cindy Gombaut, Bharat Ranganath, Jerry Chao","doi":"10.1097/SAP.0000000000004069","DOIUrl":"10.1097/SAP.0000000000004069","url":null,"abstract":"<p><strong>Purpose: </strong>Gender-affirming bottom surgeries (GABS) play a central role in treating gender dysphoria to improve quality of life for transgender and nonbinary (TGNB) patients. However, there exists limited data on operative risks and outcomes for patient populations undergoing GABS. The goal of this study is to identify sociodemographic and clinical risk factors for determining 30-day postoperative complications in patients undergoing GABS.</p><p><strong>Methods: </strong>The ACS - NSQIP database from 2010 to 2020 was used to identify patients undergoing gender affirmation surgery (GAS) using Current Procedural Terminology (CPT) codes included in transfeminine and transmasculine bottom surgery. IBS-SPSS software was used to perform a multivariate analysis to determine risk factors for increased 30-day postoperative complications including unplanned reoperation and readmission rates.</p><p><strong>Results: </strong>A total of 1809 GABS were performed in the NSQIP database from 2010 to 2020. There was an upward trend in GABS procedures throughout the years, with 2017 having the most GABS (n = 629). Transmasculine patients with a BMI of 29 and over were at a greater risk for wound complications ( P < 0.05). Diabetic transfeminine patients were also at a greater risk for wound complications ( P < 0.05).</p><p><strong>Conclusions: </strong>This study identified that several sociodemographic and clinical risk factors, such as BMI and diabetes mellitus type 2, had increased postoperative complications for patients undergoing gender-affirming bottom surgeries. Wound care management and patient education are essential in GABS to prevent long-term complications. Physician awareness of risk factors and social determinants of health can help prevent and improve postoperative care education and patient compliance.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"94-99"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142124650","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":"Modified Intravascular Stent for Microvascular Suture in a Rat Superficial Femoral Artery.","authors":"Kosuke Maeda, Taku Suzuki, Yohei Masugi, Osahiko Tsuji, Takuji Iwamoto, Masaya Nakamura","doi":"10.1097/SAP.0000000000004098","DOIUrl":"10.1097/SAP.0000000000004098","url":null,"abstract":"<p><strong>Background: </strong>Intravascular stent (IVaS) is sometimes used for suturing small vessels, but removing the stent after suturing is difficult. To overcome this problem, we developed an IVaS that integrates a stent and a manipulating string. This study aimed to investigate the usefulness of the modified IVaS (M-IVaS) by comparing it with conventional sutures (CS) and conventional IVaS (C-IVaS).</p><p><strong>Methods: </strong>Forty-five superficial femoral arteries from rats were resected and sutured. The rats were randomly divided into the following 3 groups: CS, M-IVaS, and C-IVaS, with 15 rats per group. Patency rate, operating time, and ultrasonographic blood flow dynamics were examined immediately after suturing. Patency tests, ultrasonographic evaluations, and histological investigations were performed 1 week (n = 5), 2 weeks (n = 5), and 6 weeks (n = 5) after surgery.</p><p><strong>Results: </strong>The 3 groups showed vessel patency in all cases immediately after suturing and at 1 week, 2 weeks, and 6 weeks after surgery. The mean operative time was 22.6 minutes for the CS group, 21.5 minutes for the M-IVaS group, and 25.9 minutes for the C-IVaS group. There were no significant differences in peak flow velocity and stenosis rate among the 3 groups as evaluated by ultrasonography. Histopathological evaluation revealed a similar recovery process of endothelial cells and no damage to the vascular wall.</p><p><strong>Conclusion: </strong>The surgical time using M-IVaS was significantly shorter compared to that using C-IVaS. The M-IVaS reduced the inconvenience of C-IVaS removal. M-IVaS showed the same effectiveness as did the CS in terms of patency rate, operating time, ultrasonographic blood flow dynamics, and histological evaluation. M-IVaS can be used in the field of microsurgery.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"107-113"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360864","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":"Subscapular Tunneling to Increase the Reach of Latissimus Dorsi Myocutaneous Flap: A Case Report.","authors":"Ronnie Mubang, Mae Wimbiscus, Lauren Sullivan, Alexander Nixon, Micheal Golinko, Bhandari Panambur","doi":"10.1097/SAP.0000000000004132","DOIUrl":"10.1097/SAP.0000000000004132","url":null,"abstract":"<p><strong>Abstract: </strong>The latissimus dorsi muscle or myocutaneous flap (LDMF) has long been a mainstay in the plastic surgeon's armamentarium, serving as a versatile and reliable tool for reconstructive procedures. Tunneling the LDMF through the subscapular route increases the reach to cover defects as far as nape of the neck. In this article, we report a case of LDMF routed through a subscapular route to cover impending hardware exposure at the nape region. This article provides a comprehensive review of the subscapular tunneled LDMF technique while discussing its indications, surgical anatomy, operative technique, complications, and outcomes.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 1","pages":"68-69"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811919","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":"Choke Anastomosis: A Key Element Acting as a Shunt Converter Between Adjacent Angiosomes.","authors":"Zilong Cao, Hu Jiao, Cheng Gan, Tiran Zhang, Jia Tian, Rui Li, Qiang Yue, Ningbei Yin, Liqiang Liu","doi":"10.1097/SAP.0000000000004079","DOIUrl":"10.1097/SAP.0000000000004079","url":null,"abstract":"<p><strong>Background: </strong>Choke anastomosis is commonly recognized as a resistance factor that detrimentally affects the hemodynamics of the skin flap; however, its additional potential physiological roles in normal skin function are currently not fully understood.</p><p><strong>Methods: </strong>Ten cadaveric forehead flap specimens pedicled with unilateral STAs were perfused with lead oxide-gelatin mixture, and then dissected into 3 layers, including the super temporal fascia-frontalis-galea aponeurotica layer, the subcutaneous adipose tissue layer, and the \"super-thin flap\" layer. The forehead flap and stratified specimens underwent molybdenum target x-ray and subsequent transparent processing to effectively visualize the microscopic spatial architecture of arterial vessels across all levels.</p><p><strong>Results: </strong>Based on the different anastomoses near the midline area of the flap, 2 types of arterial perfusion were identified: choke anastomosis type (8/10) and true anastomosis type (2/10). The former formed multiple choke anastomoses near the midline. In the \"super-thin flap\" layer, arterial perfusion density on the ipsilateral side was significantly higher compared to that on the contralateral side. The arterioles on the ipsilateral side exhibited a dense and uninterrupted distribution, whereas those on the contralateral side appeared sparse and dispersed. The latter exhibited an alternative perfusion pattern; the bilateral arterial vessels were connected with 3 to 5 true anastomoses near the midline. Furthermore, the microscopic architecture confirmed a uniform distribution of arterioles that remained continuous from ipsilateral to contralateral sides in the \"super-thin flap\" layer.</p><p><strong>Conclusion: </strong>This study demonstrated that choke anastomosis not only impairs blood perfusion in the adjacent angiosomes but also acts as a shunt converter to impact the blood supply of distal skin flaps at different levels through the \"trans-territory diversion phenomenon.\" This results in necrosis of the superficial dermis while preserving survival of the deep subcutaneous adipose tissue.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"100-106"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142360959","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":"Physiological and Functional Restoration of the Modiolus Using a Double Tendon Sling in Patients With Full-Thickness Oral Defects.","authors":"Taku Maeda, Toshihiko Hayashi, Kosuke Ishikawa, Takahiro Miura, Emi Funayama, Yuhei Yamamoto","doi":"10.1097/SAP.0000000000004129","DOIUrl":"10.1097/SAP.0000000000004129","url":null,"abstract":"<p><strong>Background: </strong>Reconstruction of the oral modiolus should be considered for facial defects involving the lip and cheek. We have performed free flap reconstruction using a novel technique that includes a vertical and a horizontal sling for full-thickness defects involving the oral commissure.</p><p><strong>Patients and methods: </strong>We used a free radial forearm flap and the palmaris longus tendon to correct lip and cheek defects in 6 patients (3 men, 3 women; age, 55-84 years). The tendon was divided into 2 portions for use as the double sling. One sling was used to connect the upper and lower stumps of the orbicularis oris in the vertical direction and the other to connect the vertical sling and masseter muscle. The outcomes assessed were esthetic appearance and functional results.</p><p><strong>Results: </strong>The facial defects ranged in size from 3.0 cm × 4.0 cm to 7.0 cm × 6.0 cm and the mucosal defects from 1.5 cm × 4.0 cm to 6.5 cm × 5.0 cm. The length of the harvested tendon ranged from 11.5 to 13.5 cm. All flaps survived without complications. Good esthetic outcomes were achieved (excellent facial appearance, n = 1; no lip deviation or drooping, n = 5). Functionally, all patients had acceptable mouth opening and were able to eat a regular diet.</p><p><strong>Conclusions: </strong>Good physiological and functional results can be achieved using a double tendon sling for reconstruction of the modiolus in patients with full-thickness defects involving the oral commissure.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"70-74"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543254","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":"Trends in Medicare Reimbursement for Gender-Affirming Procedures.","authors":"John Corbett, Mira Johnson, Cindy Gombaut, Bharat Ranganath, Jerry W Chao","doi":"10.1097/SAP.0000000000004134","DOIUrl":"10.1097/SAP.0000000000004134","url":null,"abstract":"<p><strong>Background: </strong>Medicare reimbursement rates are essential knowledge for gender-affirming plastic surgeons. The goal of this project was to examine trends in Medicare reimbursement rates for gender-affirming plastic surgery procedures from 2007 to 2020.</p><p><strong>Methods: </strong>Changes in reimbursement rates were measured for 35 commonly used gender-affirming procedure CPT codes from 2007 to 2020 adjusted for inflation to the 2020 US dollar value. The Unadjusted Percent Change in Consumer Price Index (CPI) was calculated using data from the US Bureau of Labor Statistics. Reimbursement rates were adjusted for inflation using the CPI for each year. Student t test was utilized for mean comparisons.</p><p><strong>Results: </strong>Mean percent change in reimbursement rates was +16.01% while the percent change in CPI was +27.45%. Comparison between rate change of inflation versus rate change in adjusted medical reimbursement was significantly higher in the inflation group ( P < 0.0001). Inflation adjustments for the Compound Annual Growth Rate was negative (-0.76%). The adjusted total percent change was also calculated at an average of -8.97%.</p><p><strong>Conclusions: </strong>This is the first study evaluating trends in Medicare reimbursement rates for commonly selected gender-affirming procedures in the United States. After adjusting for inflation, Medicare reimbursement rates for all gender-affirming surgeries analyzed declined from the years 2007 to 2020 compared to expected inflation base. Increased consideration of these trends will be important for US policymakers, hospitals, and surgeons to ensure ease of access to gender-affirming care for transgender individuals.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":"79-83"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613625","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":"Assessing the Reliability of YouTube Content for Plastic Surgery Patient Information in Africa With the Modified DISCERN and JAMA Scores.","authors":"Umutoni Alice, Shirley S Dadson, Emmanuel Edeh, Mbonu G Ndudi, Piel P Kuol, Theophilus Barasa, Okojie S Ojamah, Kwadwo A B Nkansah-Poku, Emmanuel B Nyarko, Ebenisha Choonya Majata, Ulrick Sidney Kanmounye","doi":"10.1097/SAP.0000000000004186","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004186","url":null,"abstract":"<p><strong>Introduction: </strong>YouTube has become a popular source of health information, including plastic surgery. Given the platform's wide reach and potential influence on patient decisions, this study aimed to assess the quality of information available on YouTube for African audiences seeking plastic surgery procedures.</p><p><strong>Methods: </strong>This cross-sectional study extracted data from YouTube videos on plastic surgery relevant to Africa. A search strategy identified videos in English using keywords. The first 50 results for each term were included, with duplicates removed. Next, the metadata of videos published from inception to June 9, 2024, were extracted. Two reviewers independently assessed videos using standardized tools to evaluate reliability (modified DISCERN and JAMA criteria) and engagement (likes-to-views ratio [LVR] and comments-to-views ratio [CVR]). The Mann-Whitney U test was used for unadjusted bivariable comparisons. Then ordinal logistic and beta regression analyses were used to evaluate the primary (modified DISCERN and JAMA scores) and secondary (LVR and CVR) outcomes, with a statistical significance level set at 0.05.</p><p><strong>Results: </strong>Eight hundred ninety-seven plastic surgery videos were analyzed, and 3.9% were published by African entities. Large subscriber count (coefficient = -6.9e-8, 95% confidence interval [CI] [-1.13e-7, -2.9e-8], P = 0.001), African-authored (coefficient = -0.85, 95% CI [-1.44, -0.25], P = 0.005), and advertising (coefficient = -1.01, 95% CI [-1.63, -0.57], P < 0.001) videos had lower modified DISCERN scores. Advertising videos equally had lower JAMA scores (coefficient = -1.29, 95% CI [-1.83, -0.74], P < 0.001). Academic videos had lower LVR (coefficient = -0.48, 95% CI [-0.66, -0.30], P < 0.001), whereas independent videos had higher LVR (coefficient = 0.40, 95% CI [0.26, 0.54], P < 0.001). Academic videos had lower CVR (coefficient = -0.40, 95% CI [-0.67, -0.13], P = 0.003), whereas videos with other purposes had higher CVR (coefficient = 0.37, 95% CI [0.10, 0.64], P = 0.007).</p><p><strong>Conclusions: </strong>This study underscores a potential disparity in the quality of online plastic surgery information based on video sources and purposes.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891637","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":"Leonard T. Furlow, MD.","authors":"Bruce A Mast","doi":"10.1097/SAP.0000000000004170","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004170","url":null,"abstract":"","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891441","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":"Positioning of the Inferior Alveolar Nerve and Surgical Implications: A Study on Thai Mandibles.","authors":"Chirakan Charoenvicha, Wachiranun Sirikul, Ditsayanin Thaweethanasit, Pailin Kongmebhol, Chakri Madla, Puttan Wongtriratanachai","doi":"10.1097/SAP.0000000000004185","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004185","url":null,"abstract":"<p><strong>Background: </strong>The inferior alveolar nerve (IAN), a crucial branch of the trigeminal nerve, innervates the mandible. Precise knowledge of IAN positioning ensures surgical safety.</p><p><strong>Methods: </strong>This cross-sectional study analyzed head and neck computed tomography scans from Maharaj Nakorn Chiang Mai Hospital. Inclusion criteria comprised dentate adults. Exclusion criteria included mandibular trauma/pathology or prior surgery. The study aimed to determine IAN positioning relative to key surgical landmarks: the first molar, lingula, and mental foramen.</p><p><strong>Results: </strong>A total of 450 Thai mandibles (900 hemimandibles) with a mean age of 36 years (58.2% male) were included. No significant differences were observed in IAN positioning relative to the first molar between the left and right sides in superior and inferior landmarks. However, the buccal distance was significantly closer on the left. The lingula distance was higher on the left, whereas that to the mental foramen was lower.</p><p><strong>Conclusion: </strong>Surgical implications suggest maintaining a 15-mm distance from the lower mandibular border during osteotomy and upper plate placement, restricting horizontal cuts within this 15-mm range from the lingula, and ensuring screws do not extend more than 7 mm from the buccal surface. This study provides valuable guidance for minimizing the risk of iatrogenic injury to the IAN.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891443","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":"Progression of Pilot Trials to Completed Randomized Controlled Trials in Plastic Surgery: A Systematic Review.","authors":"Andrew T Chen, Tara Behroozian, Tal Levit, Faisal Quadri, Patrick J Kim, Lucas Gallo, Jeslyn Chen, Ted Zhou, Dalya Cohen, Emily Dunn, Achilles Thoma","doi":"10.1097/SAP.0000000000004182","DOIUrl":"https://doi.org/10.1097/SAP.0000000000004182","url":null,"abstract":"<p><strong>Purpose: </strong>Well-designed pilot trials are essential in determining feasibility prior to initiating definitive randomized controlled trials (RCTs) and their implementation into clinical practice. The primary outcome of this study was to identify the number of pilot or feasibility studies in Plastic Surgery that progressed to a definitive RCT. Secondary outcomes included a) number of pilot studies expressing feasibility statements and outcomes and b) reporting quality.</p><p><strong>Methods: </strong>MEDLINE, Embase, Web of Science, and clinicaltrials.gov were searched for all pilot RCTs and definitive RCTs in plastic surgery between 2012-2023. Pilot trials were matched to definitive RCTs by keyword, author, and citation report. Feasibility outcomes were presented using descriptive statistics. Reporting quality was evaluated using the Consolidated Standards of Reporting Trials 2010 randomized pilot and feasibility trials extension.</p><p><strong>Results: </strong>Among 11,540 and 6035 citations screened in 2 separate literature searches, 171 pilot studies and 779 definitive RCTS were included, respectively. Ten (5.8%) pilot studies were associated with a completed RCT, 4 (2.3%) were in progress, and 2 (1.2%) were stopped. For studies that did not progress to a definitive RCT, \"inadequate funding\" (n = 11, 41.4%) was the most cited reason followed by \"insufficient efficacy to justify study progression\" (n = 5, 17.3%). The average reporting adherence to the Consolidated Standards of Reporting Trials items was 65.6% (SD 16). Fifty (29.2%) pilot RCTs reported a feasibility statement and 30 (17.5%) reported feasibility outcomes.</p><p><strong>Conclusions: </strong>Few pilot trials in plastic surgery progressed to a definitive RCT, and most did not present feasibility statements or outcomes. Pilot studies should precede RCTs and include clear feasibility statements and outcomes.</p>","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799289","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}